Abstract

The aim of the present study is to report the clinicopathologic features of 2 new cases of ameloblastic fibrosarcoma (AFS). Case 1 was a 9-year-old boy presenting with a painful ulcerated swelling in the posterior mandible causing facial asymmetry. Case 2 presented as an asymptomatic swelling in the anterior mandible of a 14-year-old female patient. Imaging exams revealed destructive multilocular radiolucencies with irregular margins, associated with impacted teeth, causing exuberant cortical expansion and tooth displacement. Microscopically, both cases showed mesenchymal cells with marked hypercellularity and nuclear pleomorphism containing small islands of odontogenic epithelium with peripheral palisading. Both patients were treated by surgical excision; case 1 showed recurrence after 2 years of follow-up. AFS usually affects the posterior mandible of young adults with previous history of ameloblastic fibroma; nevertheless, clinicians should also consider this rare odontogenic sarcoma when evaluating aggressive ill-defined radiolucent lesions in the mandible of pediatric patients.

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