Extensive ameloblastic fibroma of the mandible: Report of a case with a special reference to its aspiration cytologic findings

Abstract

Ameloblastic fibroma (AF) is an extremely rare benign odontogenic tumor with a relative frequency between 1.5% and 4.5%, which usually occurs in the first two decades of life. AF is a true mixed tumor, in which the epithelial and the ectomesenchymal elements are neoplastic. There are two variants of AF: Neoplastic and hamartomatous. Although the histopathology of hamartomatous and neoplastic variants of AF are indistinguishable, clinical, and radiologic features can be of some help to distinguish between them. Asymptomatic small unilocular lesions with no or minimal bone expansion in young individuals are likely to be developing odontomas, and large, expansile lesions with extensive bone destruction are neoplasms. We herein describe a massive AF involving mandible in a 12-year-old female patient, suggestive of the neoplastic variant, with a special reference to its aspiration cytologic findings. Fine-needle aspiration cytologic smears showed two different types of cellular elements: A gland like epithelial component, arranged in well-outlined clusters of basaloid cells with palisading of the columnar cells at the borders of those clusters, and a mesenchymal component that consisted of loosely arranged fusiform cells. These cytologic features appear to be sufficiently characteristic to suggest a diagnosis of AF by fine-needle aspiration. However, the confirmatory diagnosis was made on the basis of histopathology, which proved it to be an AF.