Beverly Y Wang
Pathology 2014, 46: S18
Ameloblastic fibrosarcoma (AFS) of odontogenic origin involving mandible is very rare, which is the malignant counterpart of ameloblastic fibroma with fibrosarcomatous differentiation in mesenchymal stroma admixed with benign ameloblastic epithelium. A 27-year-old white male presented with a rapidly expanding radiolucent mandibular body mass. Extraoral examination revealed a large firm swelling in the region of the left mandibular body. No associated lymphadenopathy or sensory/motor neurological impairment. Mandibular function and range of motion were normal. Intraoral examination revealed buccal expansion in the body of the left mandible with normal overlying mucosa. There was no abnormal mobility or displacement of the associated dentition. Radiograph demonstrated a radiolucent, multi-locular lesion with ill defined borders. CT scan displayed a bulky, erosive and enhancing lesion of the body and ramus of the mandible. Biopsy was performed and was diagnosed as AFS. The patient was successfully treated with a composite resection of the affected mandible and immediate fibular free flap reconstruction.This case review provides detailed pathological diagnostic features and differentials. Aggressive treatment of AFS, including resection with negative margins is the treatment of choice.

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