Mandibular ameloblastic fibroma: enucleation and 3 years follow up. Case report and literature review

Abstract

Background: Ameloblastic fibroma (AF) is an uncommon benign neoplasm formed by proliferative odontogenic epithelium immersed in an ectomesenchymal matrix. The age range of appearance varies between 0 and 6 decades of life, showing a clear predilection for the first and second decade. It occurs in males and females in similar proportions and usually are located in the posterior sites of the mandible. Clinically, it is manifested with a slow growth swelling, with or without symptoms. The treatment can be conservative (enucleation and curettage) or radical (block resection), nevertheless both modalities may have recurrences. We present a clinical case of a 30 years healthy patient with asymptomatic and great paramandibular swelling of two years of evolution diagnosed like ameloblastic fibroma, and the treatment with enucleation and curettage. Objectives: The aim of this case presentation is to show the surgical management and clinical imagenological follow-up of a mandibular AF treated by conservative techniques (enucleation and curettage). Methods: Through a vestibular mandibular intraoral approach, there has been made a enucleation of a high size lesion situated in left posterior mandibular site and placing a reconstruction plate. Three years follow up has been made with orthopantomography and computed tomography scan. Findings and Conclusion: AF can be treated by conservative techniques but require a closed clinical and imagenological control. Nevertheless, it is important to considerate the high rate of recurrence and the possibility of eventual malignisation.