Ameloblastic Fibrosarcoma: Report of a New Case †
by
Andrea Tesei
1,*, 
Marco Mascitti
2,
Filiberto Mastrangelo
3, 
Vera Panzarella
4,
Alessandra Nori
1 and
Andrea Santarelli
2 1
Department of Surgical and Special Odontostomatology Umberto I General Hospital, Marche Polytechnic University, 60126 Ancona, Italy
2
Department of Clinical Specialistic and Dental Sciences, Marche Polytechnic University, 60126 Ancona, Italy
3
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
4
Department of Surgical, Oncological and Oral Sciences, University of Palermo (DICHIRONS), 90127 Palermo, Italy
*
Author to whom correspondence should be addressed.
†
Presented at the XV National and III International Congress of the Italian Society of Oral Pathology and Medicine (SIPMO), Bari, Italy, 17–19 October 2019.
Proceedings 2019, 35(1), 79; https://doi.org/10.3390/proceedings2019035079
Published: 12 December 2019
(This article belongs to the Proceedings of The XV National and III International Congress of the Italian Society of Oral Pathology and Medicine)
Ameloblastic fibrosarcoma (AFS) is defined as a malignant mesenchymal tumor in which the epithelial component is cytologically benign and the mesenchymal component shows cytological features of malignancy [1]. AFS is the most common subtype of odontogenic sarcomas and is considered to be the malignant counterpart of fibromas of odontogenic origin [2].
AFS can occur in patients of any age, with more frequent manifestations in the third decade, predominantly male (M:F ratio of 1.5). Histologically, stromal component of AFS is characterized by malignant features of sarcoma.
Clinically, AFS grows progressively, resulting painful in many cases and causing dysesthesia or paresthesia when it involves the nerves. The non-specific symptomatology makes diagnosis difficult. AFS always appears as a radiolucent lesion with irregular margins, mainly located in the mandible. Although treatment is predominantly surgical, recurrence and metastasis rates are high.
A 55-year-old patient was reported for the evaluation of a worsening swelling from right mandibular area accompanied by pain on palpation.
Palpation revealed a non-tender, non-fluctuant and hard swelling. The neck was soft with no evidence of lymphadenopathy or tenderness. Radiographic examination was conducted using panoramic radiograph and Cone Beam Computed Tomography (CBCT), revealing a radiolucent lesion on the left mandible, closely associated with the element 4.5 and the mandibular canal.
Under general anesthesia a mucoperiosteal flap was conducted in vestibular surface of right mandibula from 4.7 area to 3.2. Using piezoelectric bone scalpel. Osteotomy was performed and the lesion were enucleated.
Histopathology showed malignant features of sarcoma, such as nuclear crowding, with hypercellularity and variable degrees of cytological atypia. On the contrary, the odontogenic epithelial component is bland and cytologically benign. The histopathological features suggested diagnosis of AFS.
A new resection, after planning on stereolithographic models, was necessary for the extension of the surgical margins and to reduce the risk of recurrence, with the colleagues of the Sant’Orsola hospital in Bologna. Post operation period was favorable for the patient.
Conflicts of Interest
The authors declared no conflicts of interest.
References
- El-Naggar, A.; Chan, J. WHO Classification of Head and Neck Tumours, 4th ed.; IARC: Lyon, France, 2017; p. 214. [Google Scholar]
- Mascitti, M.; Togni, L. Peripheral Odontogenic Myxoma: Report of Two New Cases with a Critical Review of the Literature. Open Dent. J. 2018, 12, 1079–1090. [Google Scholar] [CrossRef]
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MDPI and ACS Style
Tesei, A.; Mascitti, M.; Mastrangelo, F.; Panzarella, V.; Nori, A.; Santarelli, A. Ameloblastic Fibrosarcoma: Report of a New Case. Proceedings 2019, 35, 79. https://doi.org/10.3390/proceedings2019035079
AMA Style
Tesei A, Mascitti M, Mastrangelo F, Panzarella V, Nori A, Santarelli A. Ameloblastic Fibrosarcoma: Report of a New Case. Proceedings. 2019; 35(1):79. https://doi.org/10.3390/proceedings2019035079
Chicago/Turabian StyleTesei, Andrea, Marco Mascitti, Filiberto Mastrangelo, Vera Panzarella, Alessandra Nori, and Andrea Santarelli. 2019. "Ameloblastic Fibrosarcoma: Report of a New Case" Proceedings 35, no. 1: 79. https://doi.org/10.3390/proceedings2019035079
