Ameloblastic Fibro-Odontoma in a 16-Month-Old Male: A Case Report and Literature Review

Ameloblastic fibro-odontoma (AFO) is a rare benign mixed odontogenic tumor characterized by both soft tissue proliferation and dental hard tissue formation. This case report presents a 16-month-old male with AFO in the anterior mandible, representing one of the youngest documented cases. The patient presented with progressive facial swelling first noted at 10 months of age. Clinical examination revealed facial asymmetry with non-tender buccal expansion, while CT imaging demonstrated a well-defined 23×28mm lytic lesion with internal calcifications in the right parasymphyseal region. Treatment consisted of conservative surgical enucleation and curettage under general anesthesia, with extraction of involved teeth. Histopathological analysis confirmed the diagnosis of AFO, showing islands of ameloblastic epithelium within mesenchymal stroma and evidence of dentin and cementum formation. A literature review of AFO cases in children under 5 years (2014-2024) yielded eight cases with equal gender distribution and no clear predilection for maxilla versus mandible. All reported cases showed lesional expansion, and most were treated with enucleation and curettage with no recurrence noted during follow-up periods. The patient recovered uneventfully with resolution of facial asymmetry and showed no signs of recurrence at six-month follow-up. This case highlights that AFO could manifest at an exceptionally young age, expanding the recognized age range and underscoring the effectiveness of conservative surgical management for this rare odontogenic tumor.