법랑모세포섬유-치아종으로부터 발생한 법랑모세포섬유육종 -증례보고-

Abstract

Ameloblastic fibrosarcoma (AFS) is an extremely rare malignant odontogenic tumor characterized with benign ameloblastic cells islands and malignant mesenchymal component. While two-thirds of AFS seem to arise de novo, but one-third develops from recurrent ameloblastic fibroma (AF) or ameloblastic fibro-odontomas (AFO). Pathological distinction of malignant transformation is essential for appropriate treatment. The patient was a 28 years old man. Since the primary tumor was excised, the mass recurred 2 years later. The recurrent tumor was diagnosed as AFS. Chief complaint was pain in the right mandible. Computer tomography finding revealed multilocular intrabony lesion with radiopaque substance in the primary lesion. In the recurrent lesion cortical bone destruction was found. Microscopically, both the primary and recurrent lesions showed benign ameloblastic follicles with myxoid or highly cellular mesenchymal proliferation. The histological difference between primary and recurrent lesions were that foci of dental hard tissue composed of enamel and dentin were found only in the primary lesion, whereas nuclear pleomorphism was aggrevated in the recurrent lesion. The histological criteria determining malignancy were discussed.