An Aggressive Ameloblastic Fibroma in Maxilla of a 5-Year-Old Child—Reconstruction of the Defect with Buccal Flap Advancement—A Conservative Approach
Affiliation(s)
Department of Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurgaon, India.
Department of Maxillofacial Surgery, Faculty of Dental Sciences, SGT University, Gurgaon, India.
ABSTRACT
Ameloblastic fibroma (AF) is a rare tumour of mixed odontogenic origin that can occur either in mandible or maxilla but is most frequently found in the posterior region of mandible. Age of occurrence is generally between first and second decades of life. It is often mistaken for a den tigerous cyst due to presence of an impacted tooth. The diagnosis of AF usually occurs accidentally by routine radiographic examination for an impacted tooth. Histologically it consists of odontogenic ectomesenchyme resembling the dental papilla, epithelium resembling dental lamina and enamel organ without dental hard tissues. There is controversy in the literature as to whether the treatment should be conservative or a radical resection should be done. A conservative treatment strategy, such as enucleation and curettage, is usually sufficient. We describe a case of massive ameloblastic fibroma in a 5-year-old child with an unusual position in maxillary posterior region and without any impacted tooth. Surgical resection of the tumor through Weber Ferguson approach was done under GA with 2 years of follow-up without any recurrence.
Ameloblastic fibroma (AF) is a rare tumour of mixed odontogenic origin that can occur either in mandible or maxilla but is most frequently found in the posterior region of mandible. Age of occurrence is generally between first and second decades of life. It is often mistaken for a den tigerous cyst due to presence of an impacted tooth. The diagnosis of AF usually occurs accidentally by routine radiographic examination for an impacted tooth. Histologically it consists of odontogenic ectomesenchyme resembling the dental papilla, epithelium resembling dental lamina and enamel organ without dental hard tissues. There is controversy in the literature as to whether the treatment should be conservative or a radical resection should be done. A conservative treatment strategy, such as enucleation and curettage, is usually sufficient. We describe a case of massive ameloblastic fibroma in a 5-year-old child with an unusual position in maxillary posterior region and without any impacted tooth. Surgical resection of the tumor through Weber Ferguson approach was done under GA with 2 years of follow-up without any recurrence.
Cite this paper
JK, D. , Sharma, A. , Sharma, S. , Arya, V. and Das, R. (2015) An Aggressive Ameloblastic Fibroma in Maxilla of a 5-Year-Old Child—Reconstruction of the Defect with Buccal Flap Advancement—A Conservative Approach. International Journal of Clinical Medicine, 6, 579-585. doi: 10.4236/ijcm.2015.68077.
JK, D. , Sharma, A. , Sharma, S. , Arya, V. and Das, R. (2015) An Aggressive Ameloblastic Fibroma in Maxilla of a 5-Year-Old Child—Reconstruction of the Defect with Buccal Flap Advancement—A Conservative Approach. International Journal of Clinical Medicine, 6, 579-585. doi: 10.4236/ijcm.2015.68077.
References
[1] Jones, A.V. and Franklin, C.D. (2006) An Analysis of Oral Andmaxillofacial Pathology Found in Children over a 30-Year Period. International Journal of Paediatric Dentistry, 16, 19-30.
http://dx.doi.org/10.1111/j.1365-263X.2006.00683.x [2] Costa, D.O., Alves, A.T., Calasans-Maia, M.D., Cruz, R.L. and Lourenço Sde, Q. (2011) Maxillary Ameloblastic Fibroma: A Case Report. Brazilian Dental Journal, 22, 171-174.
http://dx.doi.org/10.1590/S0103-64402011000200015 [3] Kramer, I.R.H., Pindborg, J.J. and Shear, M. (1992) Histological Typing of Odontogenic Tumors. 2nd Edition, WHO International Histological Classification of Tumors, Springer Verlag, Berlin, 16-18.
http://dx.doi.org/10.1007/978-3-662-02858-2 [4] Philipsen, H.P., Reichart, P.A. and Praetorius, F. (1997) Mixed Odontogenic Tumours and Odontomas. Considerations on Interrelationship. Review of the Literature and Presentation of 134 New Cases of Odontomas. Oral Oncology, 33, 86-99.
http://dx.doi.org/10.1016/S0964-1955(96)00067-X [5] Trodahl, J.N. (1972) Ameloblastic Fibroma. A Survey of Cases from the Armed Forces Institute of Pathology. Oral Surgery, Oral Medicine, Oral Pathology, 33, 547-558.
http://dx.doi.org/10.1016/0030-4220(72)90367-2 [6] Chindia, M.L., Akama, M.K. and Awange, D.O. (2005) Ameloblastic Fibroma at the University of Nairobi Dental Hospital. East African Medical Journal, 82, 418-421. [7] Rao, S.P., Srivastava, G. and Smitha, B. (2012) Ameloblastic Fibroma. Journal of Oral and Maxillofacial Pathology, 16, 444-445.
http://dx.doi.org/10.4103/0973-029X.102515 [8] Martín-Granizo López, R., Ortega, L., González Corchón, M.A. and Berguer Sández, A. (2003) Ameloblastic Fibroma of the Mandible. Report of Two Cases. Med Oral., 8, 150-153. [9] Chen, Y., Wang, J.M. and Li, T.J. (2007) Ameloblastic Fibroma: A Review of Published Studies with Special Reference to Its Nature and Biological Behavior. Oral Oncology, 43, 960-969.
http://dx.doi.org/10.1016/j.oraloncology.2007.05.009 [10] Muller, S., Parker, D.C., Kapadia, S.B., Budnick, S.D. and Barnes, E.L. (1995) Ameloblastic Fibrosarcoma of the Jaws. A Clinicopathologic and DNA Analysis of Five Cases and Review of the Literature with Discussion of Its Relationship to Ameloblastic Fibroma. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 79, 469-477.
http://dx.doi.org/10.1016/S1079-2104(05)80130-1 [11] Takeda, Y., Kaneko, R. and Suzuki, A. (1984) Ameloblastic Fibrosarcoma in the Maxilla, Malignant Transformation of Ameloblastic Fibroma. Virchows Archiv A Pathological Anatomy and Histopathology, 404, 253-263.
http://dx.doi.org/10.1007/BF00694891 [12] Zallen, R.D., Preskar, M.H. and McClary, S.A. (1982) Ameloblastic Fibroma. Journal of Oral and Maxillofacial Surgery, 40, 513-517.
http://dx.doi.org/10.1016/0278-2391(82)90014-3 [13] Lysell, L. and Sund, G. (1978) Ameloblastic Fibroma: Report of Two Cases. British Journal of Oral Surgery, 16, 78-85.
http://dx.doi.org/10.1016/S0007-117X(78)80060-2 [14] Mosby, E.L., Russell, D., Noren, S. and Barker, B.F. (1998) Ameloblastic Fibroma in a 7-Week-Old Infant: A Case Report and Review of the Literature. Journal of Oral and Maxillofacial Surgery, 56, 368-372. [15] Reichart, P.A. and Jundt, G. (2008) Benigne “gemischte” odontogene Tumoren. Der Pathologe, 29, 189-198. (In German)
http://dx.doi.org/10.1007/s00292-008-0996-0 [16] Sultan, A., Rao, J.D. and Jain, H. (2013) An Aggressive Ameloblastic Fibroma in a 9-Year-Old Child Treated with Buccal Fat Graft. Journal of Cranio-Maxillary Diseases, 2, 80-84.
http://dx.doi.org/10.4103/2278-9588.113583
[1] Jones, A.V. and Franklin, C.D. (2006) An Analysis of Oral Andmaxillofacial Pathology Found in Children over a 30-Year Period. International Journal of Paediatric Dentistry, 16, 19-30.
http://dx.doi.org/10.1111/j.1365-263X.2006.00683.x [2] Costa, D.O., Alves, A.T., Calasans-Maia, M.D., Cruz, R.L. and Lourenço Sde, Q. (2011) Maxillary Ameloblastic Fibroma: A Case Report. Brazilian Dental Journal, 22, 171-174.
http://dx.doi.org/10.1590/S0103-64402011000200015 [3] Kramer, I.R.H., Pindborg, J.J. and Shear, M. (1992) Histological Typing of Odontogenic Tumors. 2nd Edition, WHO International Histological Classification of Tumors, Springer Verlag, Berlin, 16-18.
http://dx.doi.org/10.1007/978-3-662-02858-2 [4] Philipsen, H.P., Reichart, P.A. and Praetorius, F. (1997) Mixed Odontogenic Tumours and Odontomas. Considerations on Interrelationship. Review of the Literature and Presentation of 134 New Cases of Odontomas. Oral Oncology, 33, 86-99.
http://dx.doi.org/10.1016/S0964-1955(96)00067-X [5] Trodahl, J.N. (1972) Ameloblastic Fibroma. A Survey of Cases from the Armed Forces Institute of Pathology. Oral Surgery, Oral Medicine, Oral Pathology, 33, 547-558.
http://dx.doi.org/10.1016/0030-4220(72)90367-2 [6] Chindia, M.L., Akama, M.K. and Awange, D.O. (2005) Ameloblastic Fibroma at the University of Nairobi Dental Hospital. East African Medical Journal, 82, 418-421. [7] Rao, S.P., Srivastava, G. and Smitha, B. (2012) Ameloblastic Fibroma. Journal of Oral and Maxillofacial Pathology, 16, 444-445.
http://dx.doi.org/10.4103/0973-029X.102515 [8] Martín-Granizo López, R., Ortega, L., González Corchón, M.A. and Berguer Sández, A. (2003) Ameloblastic Fibroma of the Mandible. Report of Two Cases. Med Oral., 8, 150-153. [9] Chen, Y., Wang, J.M. and Li, T.J. (2007) Ameloblastic Fibroma: A Review of Published Studies with Special Reference to Its Nature and Biological Behavior. Oral Oncology, 43, 960-969.
http://dx.doi.org/10.1016/j.oraloncology.2007.05.009 [10] Muller, S., Parker, D.C., Kapadia, S.B., Budnick, S.D. and Barnes, E.L. (1995) Ameloblastic Fibrosarcoma of the Jaws. A Clinicopathologic and DNA Analysis of Five Cases and Review of the Literature with Discussion of Its Relationship to Ameloblastic Fibroma. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 79, 469-477.
http://dx.doi.org/10.1016/S1079-2104(05)80130-1 [11] Takeda, Y., Kaneko, R. and Suzuki, A. (1984) Ameloblastic Fibrosarcoma in the Maxilla, Malignant Transformation of Ameloblastic Fibroma. Virchows Archiv A Pathological Anatomy and Histopathology, 404, 253-263.
http://dx.doi.org/10.1007/BF00694891 [12] Zallen, R.D., Preskar, M.H. and McClary, S.A. (1982) Ameloblastic Fibroma. Journal of Oral and Maxillofacial Surgery, 40, 513-517.
http://dx.doi.org/10.1016/0278-2391(82)90014-3 [13] Lysell, L. and Sund, G. (1978) Ameloblastic Fibroma: Report of Two Cases. British Journal of Oral Surgery, 16, 78-85.
http://dx.doi.org/10.1016/S0007-117X(78)80060-2 [14] Mosby, E.L., Russell, D., Noren, S. and Barker, B.F. (1998) Ameloblastic Fibroma in a 7-Week-Old Infant: A Case Report and Review of the Literature. Journal of Oral and Maxillofacial Surgery, 56, 368-372. [15] Reichart, P.A. and Jundt, G. (2008) Benigne “gemischte” odontogene Tumoren. Der Pathologe, 29, 189-198. (In German)
http://dx.doi.org/10.1007/s00292-008-0996-0 [16] Sultan, A., Rao, J.D. and Jain, H. (2013) An Aggressive Ameloblastic Fibroma in a 9-Year-Old Child Treated with Buccal Fat Graft. Journal of Cranio-Maxillary Diseases, 2, 80-84.
http://dx.doi.org/10.4103/2278-9588.113583