AMELOBLASTIC FIBROMAS AND FIBROSARCOMAS: A CLINICOPATHOLOGICAL STUDY OF 30 CASES

Abstract

Objective This study aimed to report the clinicopathologic features of AF/AFS from Brazil and South Africa over a 30-year period. Study Design Clinical and radiographic data were retrieved from the archives of three oral pathology services. All cases underwent a microscopic review prior to inclusion. Results Thirty cases were identified, including 25 AF and 5 AFS. Eighteen patients were male and 12 were female, with an average age of 16.6 years (range: 3-72 years). Tumors predominantly affected the posterior mandible as asymptomatic multilocular radiolucencies with an average size of 6.7 cm, causing tooth impaction and cortical expansion. Microscopically, the tumors were characterized by cellular mesenchymal components, resembling the dental papilla containing branching strands and islands of ameloblastic epithelium. AFS exhibited increased stromal hypercellularity with marked pleomorphism and considerably fewer ameloblastic islands. Hemorrhage and myxoid degeneration were commonly seen, while melanin pigmentation and stromal granular cells were rare findings. AF with dentine and enamel deposition were classified as ameloblastic fibrodentinomas and fibro-odontomas, respectively. Conclusion This study represents one of the largest well-documented series of AF/AFS, contributing additional uncommon clinicopathologic findings to the literature. This study aimed to report the clinicopathologic features of AF/AFS from Brazil and South Africa over a 30-year period. Clinical and radiographic data were retrieved from the archives of three oral pathology services. All cases underwent a microscopic review prior to inclusion. Thirty cases were identified, including 25 AF and 5 AFS. Eighteen patients were male and 12 were female, with an average age of 16.6 years (range: 3-72 years). Tumors predominantly affected the posterior mandible as asymptomatic multilocular radiolucencies with an average size of 6.7 cm, causing tooth impaction and cortical expansion. Microscopically, the tumors were characterized by cellular mesenchymal components, resembling the dental papilla containing branching strands and islands of ameloblastic epithelium. AFS exhibited increased stromal hypercellularity with marked pleomorphism and considerably fewer ameloblastic islands. Hemorrhage and myxoid degeneration were commonly seen, while melanin pigmentation and stromal granular cells were rare findings. AF with dentine and enamel deposition were classified as ameloblastic fibrodentinomas and fibro-odontomas, respectively. This study represents one of the largest well-documented series of AF/AFS, contributing additional uncommon clinicopathologic findings to the literature.