Marcucci M, Panelli SKC, Pirágine AJ, Pinto JDS, Oliveira JX

Language: English
References: 17
Page: 71-76
PDF size: 415.36 Kb.

ABSTRACT

Ameloblastic fibrosarcoma is a rare odontogenic neoplasm and is considered the malignant counterpart of ameloblastic fibroma. The diagnosis is made by histopathological and immunohistochemical evaluation, since the epithelial component remains benign and the mesenchymal component becomes malignant. Until 2012, only 72 cases were published in English-literature. This article presents a case of intraoral mass at the posterior mandible of a 23 year-old female patient. Panoramic radiography showed a multilocular radiolucent lesion with ill-defined borders and tooth involvement. The mandibular canal presented loss of architecture also. The computed tomography images (bone window) showed hypodense lesion leading to expansion, tapering and irregular destruction of cortical, and tooth involvement. Incisional biopsy was performed for histopathological evaluation. The results revealed a mixed lesion with epithelial and mesenchymal cellular proliferation. At immunohistochemical analysis, the mesenchymal portion was vimentin positive and the epithelial component was positive for cytokeratin AE1-AE3. It also showed p53 intense labeling in all tumorous cells. The final diagnosis was ameloblastic fibrosarcoma. The lesion was surgically excised with clear margins. The radiographic appearance, even imperative for treatment planning, poorly contributed to final diagnosis, which was reached by histopathological and immunohistochemical evaluations. The treatment is still controversial, without a definition regarding chemotherapy and radiotherapy as coadjutant treatment.

REFERENCES

1. Noordhoek R, Pizer ME, Laskin DM. Ameloblastic fibrosarcoma of the mandible: treatment, long-term follow-up, and subsequent reconstruction of a case. J Oral Maxillofac Surg. 2012 Dec;70(12):2930-5.

2. Khalili M, Shakib PA. Ameloblastic fibrosarcoma of the upper jaw: Report of a rare case with long-term follow-up. Dent Res J (Isfahan). 2013 Jan;10(1):112-5.

3. Wang BY. Head and neck pathology: SS13-1 Ameloblastic fibrosarcoma of mandible. Pathology. 2014 Oct;46 Suppl 2:S18.

4. Hu YY, Deng MH, Yuan LL, Niu YM. Ameloblastic fibrosarcoma of the mandible: A case report and mini review. Exp Ther Med. 2014 Nov;8(5):1463-6.

5. Loya-Solis A, González-Colunga KJ, Pérez-Rodríguez CM, Ramírez-Ochoa NS, Ceceñas-Falcón L, Barboza-Quintana O. Ameloblastic fibrosarcoma of the mandible: a case report and brief review of the literature. Case Rep Pathol. 2015;2015:245026. doi: 10.1155/2015/245026. Epub 2015 Mar 10.

6. Al Shetawi H, Alpert EH, Buchbinder D, Urken ML. Ameloblastic Fibrosarcoma of the Mandible: A Case Report and a Review of the Literature. J Oral Maxillofac Surg. 2015 Aug;73(8):1661.e1-7.

7. Pourdanesh F, Mohamadi M, Moshref M, Soltaninia O. Ameloblastic Fibrosarcoma of the Mandible With Distant Metastases. J Oral Maxillofac Surg. 2015 Jul 11.

8. Barnes L, Eveson JW, Reichart P, Sidransky D (Eds.): World Health Organization Classification of Tumours. Pathology and Genetics of Head and Neck Tumours. Lyon: IARC Press; 2005.

9. Kousar A, Hosein MM, Ahmed Z, Minhas K. Rapid sarcomatous transformation of an ameloblastic fibroma of the mandible: case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Sep;108(3):e80-5.

10. Kobayashi K, Murakami R, Fujii T, Hirano A. Malignant transformation of ameloblastic fibroma to ameloblastic fibrosarcoma: case report and review of the literature. J Craniomaxillofac Surg. 2005 Oct;33(5):352-5.

11. Zabolinejad N, Hiradfar M, Anvari K, Razavi AS. Ameloblastic fibrosarcoma of the maxillary sinus in an infant: a case report with long-term follow-up. J Pediatr Surg. 2008 Feb;43(2):e5-8.

12. Yamaguchi S, Nagasawa H, Suzuki T, Fujii E, Iwaki H, Takagi M, et al. Sarcomas of the oral and maxillofacial region: a review of 32 cases in 25 years. Clin Oral Investig. 2004 Jun;8(2):52-5.

13. Chaisuparat R, Sawangarun W, Scheper MA. A clinicopathological study of malignant odontogenic tumours. Histopathology. 2012 Jul;61(1):107-12.

14. Philipsen HP, Reichart PA. Classification of odontogenic tumours. A historical review. J Oral Pathol Med. 2006 Oct;35(9):525-9.

15. Gupta N, Barwad A, Kumar R, Rijuneeta, Vaiphei K. Ameloblastic fibrosarcoma: A cytologist's perspective. Diagn Cytopathol. 2011 Aug;39(8):598-602.

16. Gilani SM, Raza A, Al-Khafaji BM. Ameloblastic fibrosarcoma: a rare malignant odontogenic tumor. Eur Ann Otorhinolaryngol Head Neck Dis. 2014 Feb;131(1):53-6.

17. Akinyamoju AO, Olusanya AA, Adeyemi BF, Kolude B. Ameloblastic fibrosarcoma: Report of a case. J Oral Maxillofac Pathol. 2013 Sep;17(3):424-6.