Aly Noura, Amer Hatem, Khatib Omar El
Faculty of Dentistry, Cairo University, Egypt.
Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Cairo University, Egypt.
Contemp Oncol (Pozn). 2018;22(1):50-53. doi: 10.5114/wo.2018.74395. Epub 2018 Apr 3.
Ameloblastic fibro-odontoma (AFO) is an uncommon, benign, mixed odontogenic tumour occurring predominantly in children and adolescents. The purpose of this study was to report an unusual case of AFO in the mandible of a five-year-old male patient showing evidence of chondroid tissue formation. Clinical, radiographic, histopathological and immunohistochemical findings were presented. Intraoral examination revealed a swelling extending from the right deciduous lateral incisor to the left second molar area. Computed tomography (CT) showed a large, well-demarcated multilocular radiolucency with radiopaque deposits. Histologically, the lesion was composed of connective tissue stroma resembling the dental papilla, with epithelial islands, and amorphous masses of enamel and dentin consistent with a diagnosis of AFO, as well as, evidence of large areas showing cartilaginous tissue formation. Immunohistochemistry using cytokeratin, vimentin and s-100 were helpful in determining the origin of the different odontogenic tissues. Surgical excision of the lesion was performed. The patient has been monitored and the lesion has not recurred. We report the first case of AFO showing an unusual behaviour of chondroid tissue formation.
成釉细胞纤维牙瘤(AFO)是一种罕见的良性混合性牙源性肿瘤,主要发生于儿童和青少年。本研究的目的是报告一例发生在一名5岁男性患者下颌骨的AFO罕见病例,该病例显示有软骨样组织形成的证据。文中呈现了临床、影像学、组织病理学和免疫组化检查结果。口腔检查发现肿胀从右侧乳侧切牙延伸至左侧第二磨牙区。计算机断层扫描(CT)显示一个大的、边界清晰的多房性透射区,伴有不透光沉积物。组织学上,病变由类似牙乳头的结缔组织基质、上皮岛以及与AFO诊断相符的釉质和牙本质无定形团块组成,同时还有大面积显示软骨组织形成的证据。使用细胞角蛋白、波形蛋白和S-100进行免疫组化有助于确定不同牙源性组织的来源。对病变进行了手术切除。对患者进行了监测,病变未复发。我们报告了首例显示软骨样组织形成异常表现的AFO病例。