Department of Oral and Maxillofacial Surgery, Tokyo Dental College.
Division of Surgical Pathology, Clinical Laboratory, Ichikawa General Hospital, Tokyo Dental College.
Bull Tokyo Dent Coll. 2021 Mar 13;62(1):49-54. doi: 10.2209/tdcpublication.2020-0031. Epub 2021 Feb 15.
An ameloblastic fibroma (AF) is a proliferative mixed tumor which includes components of both odontogenic epithelium and mesenchymal tissue. It is a relatively rare neoplasm, accounting for approximately only 1.5-4.5% of odontogenic tumors. This case report describes an AF that occurred in the mandibular anterior tooth region in a 9-year-old girl who presented with the chief complaint of swelling in the left mandibular anterior tooth region. Intraoral examination revealed a swelling along the labial gingiva, extending from the left mandibular lateral incisor region to the left mandibular canine. Upon palpation, the swelling appeared to comprise a hard tissue. Computed tomography revealed a supernumerary impacted tooth; soft tissue density in the bone surrounding the region extending from the left mandibular lateral incisor to the left mandibular canine; labial bone expansion; and thinning of the labial cortical bone. A biopsy was performed under local anesthesia and the lesion subsequently diagnosed as an AF. Tumor resection and extraction of the supernumerary impacted tooth were carried out under general anesthesia. At 2 years postoperatively the prognosis is good. Although relapse with an AF is rarer than that with an ameloblastoma, strict follow-up is required, as malignant transformation to an ameloblastic fibrosarcoma has been reported in relapsed cases.
成釉细胞瘤(AF)是一种增殖性混合肿瘤,包括牙源性上皮和间充质组织的成分。它是一种相对罕见的肿瘤,约占牙源性肿瘤的 1.5-4.5%。本病例报告描述了一例发生在下颌前牙区的 AF,9 岁女孩因左侧下颌前牙区肿胀为主诉就诊。口腔检查显示唇侧牙龈沿肿胀,从左侧下颌侧切牙区延伸至左侧下颌尖牙。触诊时,肿胀似乎包含硬组织。计算机断层扫描显示有额外的埋伏牙;该区域周围的骨内有软组织密度影,从左侧下颌侧切牙延伸至左侧下颌尖牙;唇侧骨膨胀;唇侧皮质骨变薄。在局部麻醉下进行了活检,随后诊断为 AF。在全身麻醉下进行了肿瘤切除和多余埋伏牙的拔除。术后 2 年,预后良好。尽管 AF 的复发率低于成釉细胞瘤,但仍需严格随访,因为已有报道称复发病例可恶变为成釉纤维肉瘤。