IJCRR - Vol 07 Issue 10, May, 2015
AMELOBLASTIC FIBRO SARCOMA OF THE MANDIBLE IN A YOUNG MALE
Author: Balasubramanian A., N. S. Kannan
Category: General Sciences
Aim: Aim of this study is to report a rare case of Ameloblastic Fibro Sarcoma (AFS) of mandible arising as a denovo malignancy and to review the literature with reference to so far reported cases, nomenclature, classification, differential diagnosis and management.
Case report: A 14 year old male patient presented with complaints of a painless swelling of left side of the face since 1 year. Based on clinical presentation and investigation reports it was diagnosed as a case of AFS in left side of mandible arising as a denovo malignancy. He underwent left hemimandibulectomy ‘en bloc’ with part of the adjacent masseter and pterygoid muscles under general anaesthesia.
Discussion: Ameloblastic Fibro Sarcoma (AFS) is one of the rare histopathology variety of odontogenic tumours. The first case of AFS was reported in 1887 by Heath. Since then only 91 cases have so far been reported. This number includes both denovo and sarcomatous transformation from pre-existing ameloblastic fibroma, occurring in different sites. The most common site affected is mandible [78%]. The mean age of patients with tumours arising denovo is 22.9 years. Ours is a case of AFS arising as a denovo malignancy in left side of mandible.
Conclusion: We are presenting our case due to rarity and the limited information that exists regarding histopathology characteristics of AFS, lack of defined criteria for grading and biologic behaviour of these tumours, making the diagnosis eluding, treatment decision challenging and assessment of prognosis difficult.
Keywords: Odontogenic tumours, Denovo malignancy, Orthopantomogram, Hemimandibulectomy ‘en bloc’
Balasubramanian A., N. S. Kannan. AMELOBLASTIC FIBRO SARCOMA OF THE MANDIBLE IN A YOUNG MALE International Journal of Current Research and Review. Vol 07 Issue 10, May, 01-05
1. Heath C. Lectures on certain disease of the jaws. Br Med J. 1887;2:5–13.
2. Hu YY, Deng MH, Yuan LL, Niu YM. Ameloblastic fibrosarcoma of the mandible: A case report and mini review. Exp Ther Med. 2014;8(5): 1463–6.
3. Pontes HA, Pontes FS, Silva BS, Cury SE, Fonseca FP, Salim RA, et al. Immunoexpression of Ki67, proliferative cell nuclear antigen, and Bcl-2 proteins in a case of ameloblastic fibrosarcoma. Ann Diagn Pathol. 2010;14(6):447–52.
4. Demoor-Goldschmidt C, Minard-Colin V, Cassagneau E, Supiot S, Oberlin O, D’hautuille C, et al. Ameloblastic fibrosarcoma of the mandible: report of 2 chemosensitive pediatric cases. J Pediatr Hematol Oncol. 2012;34(2):e72–6.
5. Dallera P, Bertoni F, Marchetti C, Bacchini P, Campobassi A. Ameloblastic fibrosarcoma of the jaw: report of five cases. J Craniomaxillofac Surg. 1994;22(6):349–54.
6. Barnes, L.; Eveson, J.; Reichart, P.; Sidransky, D. WHO Classification of Head and Neck Tumors Pathology and Genetics of Head and Neck Tumours; IARC Press: Lyon, France, 2005; pp. 283-328.
7. Gilani S M, Raza A, Al-Khafaji B M. Ameloblastic fibrosarcoma: A rare malignant odontogenic tumor European Annals of Otorhinolaryngology, Head and Neck Diseases. 2014;131(1):53–56.
8. 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;43:e5–e8.
9. 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;33(5):352–55.
10. Bregni RC, Taylor AM, García AM. Ameloblastic fibrosarcoma of the mandible: report of two cases and review of the literature. J Oral Pathol Med. 2001;30(5):316– 20.
11. Khalili M, Shakib P A. Ameloblastic fibrosarcoma of the upper jaw: Report of a rare case with long-term follow-up. Dent Res J (Isfahan).2013;10(1):112–5.
12. Broca P. Recherches sur un nuveau grupe des tumeurs désignées sousle nom d’odontomes. Gaz Hebd Sci Med. 1868;5:70-84 (Research on a new group of tumors designated under the name odontomas by Mr. Paul Broca, ... [1867 Edition]).
13. Pindborg JJ, Kramer IRH. Histological Typing of Odontogenic Tumours, Jaw Cysts and Allied Lesions. 11th ed. Geneva: World Health Organization; 1971.
14. Mosqueda-Taylor A. New findings and controversies in odontogenic tumors. Med Oral Pathol Oral Cir Bucal. 2008;13(9):E555-8.