Rapid sarcomatous transformation of an ameloblastic fibroma of the mandible: case report and literature review

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Sep;108(3):e80-5. doi: 10.1016/j.tripleo.2008.07.031.

Abstract

Ameloblastic fibrosarcoma (AFS) is a rare malignant odontogenic tumour regarded as the malignant counterpart of ameloblastic fibroma. It is characterized by a benign epithelial component within a malignant fibrous stroma. AFS is a locally aggressive neoplasm with extremely low potential for metastasis. We report an extremely rare, rapidly progressive, and fatal case originating in the posterior mandible of a 20-year old female patient. Initially histopathologically diagnosed as a benign lesion, it rapidly recurred with apparent transformation into a high-grade sarcoma over a period of 6 months. Subsequent intracranial and pulmonary metastases were noted, and the patient died within 15 months of initial consultation. This case emphasizes the need for a high element of suspicion about clinically ambiguous lesions. We recommend more extensive or radical, primary excisions in lesions that have a known potential for recurrence or malignancy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Brain Neoplasms / secondary
  • Cell Transformation, Neoplastic / pathology*
  • Fatal Outcome
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / secondary
  • Mandibular Neoplasms / pathology*
  • Masseter Muscle / pathology
  • Muscle Neoplasms / pathology
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / pathology
  • Odontogenic Tumors / pathology*
  • Radiography, Panoramic
  • Sarcoma / pathology*
  • Sarcoma / secondary
  • Skull Neoplasms / pathology
  • Sphenoid Bone / pathology
  • Tomography, X-Ray Computed
  • Young Adult