Peters Scott M, Bergen Michele S, Philipone Elizabeth M, Yoon Angela J
J Clin Pediatr Dent. 2018;42(6):458-460. doi: 10.17796/1053-4625-42.6.10. Epub 2018 Aug 7.
Ameloblastic fibro-odontoma (AFO) is a rare benign odontogenic tumor with the histologic features of ameloblastic fibroma (AF) but also contains enamel and dentin. It is most commonly observed in the pediatric population. Distinction between AFO and AF becomes important as ameloblastic fibromas are associated with higher recurrence rates of up to 18%, and 35% of these recurrent lesions can undergo malignant transformation to ameloblastic fibrosarcoma. Hence, for amelobastic fibroma, conservative curettage is recommended for the initial lesion and marginal resection is considered for recurrent cases. In contrast, AFO can be treated with simple curettage and the recurrence rate is approximately seven percent. Malignant transformation of AFO is exceedingly rare. Therefore, the treatment and prognosis differs for these two histologically similar neoplasms. We present a case of a 17-year-old boy who was initially diagnosed with ameloblastic fibroma upon biopsy, with subsequent curettage specimen showing AFO, which carries a better prognosis.
成釉细胞纤维牙瘤(AFO)是一种罕见的良性牙源性肿瘤,具有成釉细胞纤维瘤(AF)的组织学特征,但也包含釉质和牙本质。它最常见于儿童人群。区分AFO和AF很重要,因为成釉细胞纤维瘤的复发率较高,可达18%,其中35%的复发病变可发生恶性转化为成釉细胞纤维肉瘤。因此,对于成釉细胞纤维瘤,对于初始病变建议采用保守刮除术,对于复发病例考虑行边缘切除术。相比之下,AFO可采用简单刮除术治疗,复发率约为7%。AFO的恶性转化极为罕见。因此,这两种组织学相似的肿瘤的治疗和预后有所不同。我们报告一例17岁男孩,最初活检诊断为成釉细胞纤维瘤,随后刮除标本显示为AFO,其预后较好。