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Highly Proliferative Ameloblastic Fibroma: A Rare Entity
Appasab Sanadi1, Sagar J Shah2, Someshwar Golgire3
1Department of Oral and Maxillofacial Surgery, Vasantdada Patil Dental College and Hospital, Sangli, Maharashtra, India.
Contemporary Clinical Dentistry
|November 28, 2019
Summary
Ameloblastic fibroma (AF), a rare jaw tumor, can mimic other conditions. This case highlights surgical resection and reconstruction for a large, aggressive mandibular AF in a young adult.
Area of Science:
- Oral and Maxillofacial Surgery
- Oncology
- Pathology
Background:
- Ameloblastic fibroma (AF) is a rare odontogenic neoplasm, typically presenting in the second decade of life, most commonly in the posterior mandible.
- AF shares clinical and radiographic similarities with other odontogenic cysts and tumors, necessitating precise histopathological and immunohistochemical analysis.
- Understanding the proliferative potential, indicated by markers like Ki67, is crucial for effective treatment planning.
Observation:
- A case of a large ameloblastic fibroma in a 21-year-old female is presented, located in the posterior mandible.
- The lesion caused significant expansion and erosion of the mandibular cortical plates and inferior border.
- Immunohistochemical analysis revealed a high Ki67 proliferative index (20%).
Findings:
- The ameloblastic fibroma demonstrated aggressive features with extensive bone involvement.
- The high Ki67 index suggested a significant proliferative potential for the tumor.
- Surgical management involved segmental resection of the affected mandible.
Implications:
- Aggressive ameloblastic fibromas require prompt and definitive surgical intervention.
- Segmental resection, while effective, can lead to morbidity in young patients, emphasizing the need for careful management.
- Immediate reconstruction using autogenous iliac grafts is a viable option for restoring mandibular continuity after extensive resection.
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