Ash Hiralal, Singh Rajeev Kumar, Anwar Eram, Banerjee Abhishek, Chatterjee Ananjan, Ramalingam Karthikeyan
Oral and Maxillofacial Surgery, Buddha Institute of Dental Sciences and Hospital, Patna, IND.
Oral and Maxillofacial Pathology, Awadh Dental College and Hospital, Jamshedpur, IND.
Cureus. 2025 May 18;17(5):e84343. doi: 10.7759/cureus.84343. eCollection 2025 May.
Ameloblastic fibro-odontoma (AFO) is an uncommon, non-cancerous odontogenic tumor that predominantly affects children and young adolescents. This case report details a nine-year-old male patient who presented with a firm swelling accompanied by intermittent serous discharge in the upper right jaw following a fall. Clinical assessment revealed incomplete mouth closure, facial asymmetry, and dentoalveolar extrusion. Radiographic analysis via cone beam computed tomography revealed a heterogeneous radiolucent lesion with focal radiopacities, thinning of the cortical plates, and a minor breach in the nasal floor, indicative of an osteolytic lesion. Differential diagnoses considered included adenomatoid odontogenic tumor and desmoplastic ameloblastoma. Routine blood tests and fine-needle aspiration cytology (FNAC) yielded negative results. The lesion was surgically enucleated under general anesthesia, with preservation of the affected teeth. Histopathological analysis confirmed the diagnosis of AFO, characterized by hyperchromatic columnar ameloblast-like cells, stellate reticulum-like cells, and basophilic dentinoid-like formation within an immature connective tissue stroma. Postoperative recovery was smooth, resulting in notable improvement in facial aesthetics and oral function. AFO is typically located in the posterior mandible, making its occurrence in the anterior maxilla unusual. Conservative surgical management is the recommended strategy and is associated with low recurrence rates. Although malignant transformation has been documented, extensive treatment is generally reserved for cases exhibiting dysplastic changes or aggressive recurrence. This case underscores the importance of early diagnosis, imaging, and histological verification for effective treatment planning. Regular follow-up is crucial to monitor for potential recurrence and to ensure favorable long-term outcomes in patients with AFO.
成釉细胞纤维牙瘤（AFO）是一种罕见的非癌性牙源性肿瘤，主要影响儿童和青少年。本病例报告详细介绍了一名9岁男性患者，该患者在跌倒后右上颌出现质地坚硬的肿胀，并伴有间歇性浆液性分泌物。临床评估显示张口受限、面部不对称和牙槽骨突出。通过锥形束计算机断层扫描进行的影像学分析显示，存在一个异质性的透射性病变，伴有局灶性阻射性区域、皮质骨板变薄以及鼻底轻度破损，提示为溶骨性病变。考虑的鉴别诊断包括腺样牙源性肿瘤和促结缔组织增生性成釉细胞瘤。常规血液检查和细针穿刺细胞学检查（FNAC）结果均为阴性。在全身麻醉下对病变进行了手术摘除，并保留了患牙。组织病理学分析证实了AFO的诊断，其特征为在未成熟的结缔组织基质内有深染的柱状成釉细胞样细胞、星网状细胞样细胞以及嗜碱性牙本质样结构。术后恢复顺利，面部美观和口腔功能有显著改善。AFO通常位于下颌骨后部，因此发生在上颌前部较为罕见。推荐的治疗策略是保守手术治疗，其复发率较低。尽管已有恶性转化的报道，但广泛的治疗通常仅适用于表现出发育异常改变或侵袭性复发的病例。本病例强调了早期诊断、影像学检查和组织学验证对于有效治疗计划的重要性。定期随访对于监测潜在复发以及确保AFO患者获得良好的长期预后至关重要。
