Ameloblastic fibroma in one-year-old girl
A 1-year-old girl child was brought by her parents to our hospital with a complaint of swelling in the mandibular right posterior region. The mother of the child noticed the swelling since 2-3 months, which gradually increased in size. Her medical, surgical, family and social history were unremarkable. A systemic review was within normal limits and no medication had been taken for this swelling.\nIntraoral examination showed a hard swelling in the right mandibular body, which was present in the canine to molar region. The overlying mucosa was intact and of normal colour. The buccal cortical plate expansion in the region of the swelling was detected [].\nThere was no evidence of pus or blood discharge from the swelling. The radiographic examination (occlusal and lateral oblique view) showed a large well defined unilocular radiolucent lesion extending from right deciduous canine to second molar region. The borders of the lesion were well defined and corticated with thinning and expansion of the inferior border of mandible and buccal cortex. The lesion was associated with a displaced developing mandibular first molar towards inferior border of mandible while second molar was displaced posteriorly [Figures and ]. The clinical diagnosis of dentigerous cyst was made. Enucleation of the lesion was advised, but the parents refused the surgical treatment.\nAgain after 3 months the patient reported with a rapid increase in the size of the swelling. A proliferative growth was evident in the mandibular right posterior region extending from canine to molar region. Approximate size of the lesion was 3 cm × 2 cm which was soft and non-tender. Right submandibular lymphadenopathy was present. Taking into consideration the sudden rapid growth, which was proliferative a clinical suspicion of a malignant lesion, ameloblastic fibrosarcoma was considered, and an incisional biopsy was performed.\nH and E stained sections showed a tumor mass made up of epithelial and mesenchymal components of odontogenic origin. The epithelial component consisted of multiple, sharply defined strands and islands which were bordered at the periphery by a layer of tall columnar cells resembling ameloblasts. The mesenchymal component is made up of primitive connective tissue consisting of closely interwining fibrils interspersed by large connective tissue cells closely resembling those of dental papilla. The histopathological diagnosis was AF [Figures and ].\nSurgical excision of the lesion with curettage of surrounding bone was performed. The post-operative course was uneventful and the patient was discharged for further follow up. On follow up healing was uneventful and there were no signs of recurrence.