palpable submandibular and cervical lymph nodes, were found. Clinical impression. Based on the persistent but ... parotid gland, followed by the submandibular gland. When this tumor involves the minor salivary ... The most common of these entities is
Mar 3, 2003 - Macroglossia may occur as a congenital or acquired condition. The enlarged tongue has both functional and cosmetic deformity, which may affect the oral airway, speech, and the development of the jaws. We discuss the various tongue-reduc
Tuberculous osteomyelitis of mandible is an extremely rare condition, particularly in comparison to pyogenic infections and neoplastic ... Oral clinical presentation may be as ulcers, ... common sites involved are tongue, gingiva, tooth sockets.
Dec 6, 2006 - Continuing education and the American College of Oral and ... Online Only Articles ... PhD, and Tolga Güvenc, DDS, PhD, Samsun, Turkey.
lidocaine with 1:80,000 epinephrine (L-E; Astra Zeneca,. Osaka, Japan). In total ..... Morrow LA, Linares OA, Hill TJ, Sanfield JA, Supiano MA,. Rosen SG, et al.
Meticulous oral hygiene is recommended to help reduce recurrence. A similar drug-induced gingival enlargement is seen in half of children taking phenytoin to control seizures, and other drugs, such as cyclosporin A, an immunosuppressive drug, and nif
treatment and understanding of autoimmune bullous diseases, hereditary bullous diseases, ... Part II will deal with the pemphigus group and other dermatological conditions with ..... The sensitivity of IIF in pemphigus vulgaris and foliaceus may.
The mean age of patients was 29.9 6 15.6 years (range, 4-85 years). ..... 4.81. 12.29. 2.66. Ameloblastic fibroma. 13.019. 5 .000*. 16.00. 19.16. 12.84.
Page 1 ...... osseous diseases into question (Cooper, 1976), as will be discussed in this section. On the most basic level the physical manifestation of a disease comes about as the ...... necrosis in crocodilians (Hibberd & Harrower, 1993), and are
Jul 10, 2011 - 'İltihabi dişeti büyümesi' klinik ... Hiperkromatik bazı hücreler gözlendi ancak mitoz ... olduğu hafif derecede kronik iltihabi hücre infiltrasyonu.
Multiple trabeculae of âblue boneâ were noted as well as numerous ..... viously called juvenile hyaline fibromatosis) patients survive into adulthood, and in the ..... pyogenic granuloma, and peripheral ossifying fibroma. We report an unusual ...
know our history, we are doomed to repeat our problems if we do not step up to the plate. As you so eloquently pointed out, oral and maxillofacial surgery began ...
Background: Endometrial cancer is the third most common malignancy of the female ... abundant mitotic figures, apoptotic bodies, and foci of necrosis. The tu- .... nography showed a diffusely enlarged uterus with multiple echogenic masses.
cal ductal hyperplasia/atypical lobular hyperplasia, ductal carcinoma in situ, and ..... noma in sclerosing lesions was mostly non-invasive (79%). The cribri-.
D Jain , S B Nair , A H Nadkarni , K Ghosh , R B Colah. Short reports. 660 Comparison of the RNA-based EndoPredict multigene test between core biopsies ...
Yoon Jin Cha âHyeon Joo Jeong. Department of .... Hye Jung Jo âSun Hee Sung .... Hyeong Ju Kwon â Myung Ju Koh â Dong Jin Joo1 â Myoung Soo Kim1.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency and ... In Sri Lanka the incidence of thalassaemia, Hb E, and G6PD deficiency corresponds to areas.
1093 Frequency, interobserver reproducibility and clinical significance of equivocal peaks in PCR clonality testing using Euroclonality/BIOMED-2 primers.
Amass casualty event (MCE) involving a large number of children is a prospect that many prehospital providers might consider to be their worst nightmare. Unfortu- nately, children may be involved in any mass casualty response. In one recent study of
Dec 12, 2016 - Different gastrointestinal disorders, such as Gastroesophageal Reflux Disease. (GERD), Celiac Disease (CD) and Crohn's ... oral signs of these systemic diseases allows an early diagnosis and treatment and could prevent related long-ter
changes are most consistent with oral warts, known as FEH or. Heck's disease. This site-specific disease represents a human papillomavirus (HPV) infection that ...
(figure 1). The immediately adjacent epithelium will frequently show pseudoepitheliomatous hyperplasia, while the ulcer bed contains granulation tissue (figure ...
accounting 9th edition harrison homework answers chapter concept review answers ... answers to cell membrane coloring worksheet answers to application ...
area, maxilla or floor of the nasal cavity. ... minor (buccal mucosa) > sublingual > submandibular > parotid. .... (âjuvenile nasopharyngeal angiofibromaâ).
DOI: 10.26717/BJSTR.2017.01.000157 Shermil Sayd. Biomed J Sci & Tech Res
Ameloblastic Fibrosarcoma - A Review of the Literature 1
Shermil Sayd* and Suresh Vyloppilli2
Kannur Dental College, India
Malankara Orthodox Syrian Church Hospital and MedicalCollege, India
Received: June 14, 2017; Published: June 29, 2017
*Corresponding author: Shermil Sayd, Al-Seyd Mahal, Vellamunda, Wayanad-670731; Tel: +919446230425; Email: Abstract Ameloblastic Fibrosarcoma is an extremely rare odontogenic tumor with unclear etiology, which has clinical and radiological features similar to other odontogenic tumors. The rarity of these neoplasms plus their overlapping features with other odontogenic tumors can make diagnosis challenging. These cases should be discussed and reviewed by oral pathologists in multidisciplinary conferences, dealing with sarcoma, at national and international level. Keywords: Ameloblastic ﬁbrosarcoma; Ameloblastic dentinosarcoma; Ameloblastic odontosarcoma Abbreviations: AFS: Ameloblastic Fibro Sarcoma; PCNA: Proliferating Cell Nuclear Antigen
Introduction The first description of the rare odontogenic tumor, ameloblastic fibrosarcoma (AFS), was in 1887 . Various terminologies like ameloblastic dentinosarcoma and ameloblastic odontosarcoma were employed in the past to denote these types of lesions, which depended upon the presence of enamel or dentin. In the recent past, multiple authors considered these lesions to be the histological variants of the same lesion and were thought to be for a long time. Recently, the World Health Organization classification of the odontogenic tumors, ameloblastic odontosarcoma, and dentinosarcoma are again separately listed. Reported cases of AFS had ages ranging from 3 to 89 years,  with a mean age of all the reported cases summing upto 27.3 years , which shows that it has a major tendency towards the younger population. The usual clinical presentation is painful, but occasionally painless facial mass. Paresthesia and dysesthesia are the next progressive symptoms. Continuance of the symptomatic episodes is also gradual and has a varied range, from a few days to two years. When analyzing various published articles reporting cases of AFS and literature reviews, it can be seen that more than 32% of the reported cases of AFS were recurrences and this points towards a slightly increased rate of recurrence which further necessitates meticulous removal of the lesion . Radiographic AFS, as per reports, is an expansile destructive mass with ill-defined and irregular borders. The gross tumor appearance varies from cystic or solid with a ﬂeshy whitish to yellow consistency, which is the cause of bone destruction. Histologically, the epithelial component mimics the developing enamel organ,
and the mesenchymal cells vary from hyperchromatic spindle to satellite and exhibit moderate to marked nuclear pleomorphism with a high number of mitotic ﬁgures. Fibroblastic presence is seen ultra structurally. Immuno histochemically, multiple reports showed that while ameloblastic fibroma shows negativity towards the p 53 and proliferating cell nuclear antigen (PCNA), AFS show positivity towards the same . Recurrent AFS shows higher labeling indices for Ki-67 as compared with non- recurrent AFS, and the same can be used to identify between the same and can be managed accordingly [5,6].
Since AFS is a rare entity, the reported literature available is very limited in nature. The oddity of the lesion does not make it exempted from the differential diagnosis of multiple lesions until proven differently. Widely acknowledged treatment modality for AFS is a combination of chemotherapy and radiotherapy, accompanied with wide surgical resection. Local control is strongly dependent on the extent of the initial resection, and conservative surgery must be abandoned and replaced by wide surgical resection with the surrounding soft tissue, particularly when the cortical plates have been perforated. As mentioned above, since more than 30-40%  of the reported cases is recurrences, the patient should be kept under long-term follow-up as the reported ages show a wide variance. Previously, curettage, enucleation, and local excision have typically been utilized in the surgical procedure  and have failed exponentially with recurrence. In multiple reported cases, it can be
Cite this article: Shermil S, Suresh V. Ameloblastic Fibrosarcoma - A Review of the Literature. Biomed J Sci & Tech Res. 1(1)-2017. BJSTR.MS.ID.000157. DOI: 10.26717/BJSTR.2017.01.000157
Shermil Sayd. Biomed J Sci & Tech Res seen that the combination or adjuvant chemotherapy is regarded as having provided complete remission of large lesions without recurrences . The most effective chemotherapeutic regimes which have most effect seems to be a daily oral cyclophosphamide, weekly intravenous actinomycin-D, and vincristine, along with postoperative radiotherapy, with maximum effect reported with 50 Gy doses. Many authors mandatorily recommend it, when the lesion is large or incomplete removal is suspected [1,8]. AFS is considered by many as a locally aggressive neoplasm with a low potential for distant metastasis (4.5%) and with an overall mortality rate of 25.4% [2,7]. Many of the authors recommend a radical resection along with primary neck dissection. However, authors like Kousar et al.  suggests that the radical surgical excision of the AFS should not be accompanied by primary neck dissection, only the surgical resection along with adjuvant chemo and/or radiotherapy is needed. Prognostic prediction for AFS is still under reviews because of the rarity of the cases . Khalili M  reported a case of AFS, which underwent radical surgical resection and radiotherapy with no evidence of recurrence or metastasis after two years, which is considered as a favorable outcome. However, many other authors are of the opinion that given the wide range of age of incidence, two years cannot be considered as a safe margin for non-recurrence [9,10,12], and further long-term case studies should be done to reach a favorable conclusion .
AFS is an extremely rare odontogenic tumor with unclear etiology, which has clinical and radiological features similar to other odontogenic tumors. The rarity of these neoplasms plus their overlapping features with other odontogenic tumors can make diagnosis challenging. However, from the available literature data, although in limited numbers, we can safely conclude that if found as AFS, it can be managed with acombination of chemotherapy and radiotherapy, accompanied with wide surgical resection. The patient should be kept under follow-up for a long term as long-term reports, and a unified recurrence data is not available.
1. Zabolinejad N, Hiradfar M, Anvari K (2008) Ameloblastic ﬁbrosarcoma
Volume 1- Issue 1: 2017
of the maxillary sinus in an infant: a case report with long term followup. J Pediatr Surg 43(2): e5-8.
2. Barnes L, Eveson J, Reichat P (2005) WHO Classiﬁcation of Head and Neck Tumors. France: IARC Press 283-328. 3. Bregni R, Taylor A, Garcia A (2001) Ameloblastic ﬁbrosarcoma of the mandible: report of two cases and review of the literature. J Oral Pathol Med 30(5): 316-320.
4. Huguet P, Castellví J, Avila M, Aleio M, Autonell F, et al. (2001) Ameloblastic Fibrosarcoma: report of a case. Immunohistochemical study and review of the literature. Med Oral 6(3):173-179.
5. Sano K, Yoshida S, Ninomiya H, Ikeda H, Ueno K, et al (1998) Assessment of growth potential by MIB-1 immunohistochemistry in ameloblastic ﬁbroma and related lesions of the jaws compared with ameloblastic ﬁbrosarcoma. J Oral Pathol Med 27(2): 359-363. 6. Williams MD, Hanna EY, El-Naggar AK (2007) Anaplastic ameloblastic ﬁbrosarcoma arising from recurrent ameloblastic ﬁbroma: restricted molecular abnormalities of certain genes to the malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 104(1): 72-75. 7. Goldstein G, Parker F, Hugh G (1976) Ameloblastic Sarcoma. Pathogenesis and treatment with chemotherapy. Cancer 37(4): 1673-1678.
8. Muller S, Parker DC, Kapadia SB, Budnick SD, Barnes EL (1995) Ameloblastic fibrosarcoma of the jaws. A clinicopathologic and DNA analysis of five cases and review of the literature with discussion of its relationship to ameloblastic fibroma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79(4): 469-477. 9. Demoor-Goldschmidt C, Minard-Colin V, Cassagneau E, Supiot S, Oberlin O et al (2012) Ameloblastic ﬁbrosarcoma of the mandible: report of 2 chemosensitive pediatric cases. J Pediatr Hematol Oncol 34(2): e72-76. 10. Kousar A, Hosein MM, Ahmed Z, Minhas K (2009) Rapid sarcomatous transformation of an ameloblastic fibroma of the mandible: case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108(3): e80-85.
11. Khalili M, Shakib PA (2013) Ameloblastic fibrosarcoma of the upper jaw: Report of a rare case with long-term follow-up. Dent Res J 10(1): 112115.
12. Kobayashi K, Murakami R, Fujii T and Hirano A (2005) Malignant transformation of ameloblastic fibroma to ameloblastic fibrosarcoma: case report and review of the literature. J Craniomaxillofac Surg 33(5): 352-355. 13. Hu YY, Deng MH, Yuan LL, Niu YM (2014) Ameloblastic fibrosarcoma of the mandible: A case report and mini review. Experimental and therapeutic medicine 8(5): 1463-1466.
Assets of Publishing with us • Global archiving of articles
• Immediate, unrestricted online access • Rigorous Peer Review Process • Authors Retain Copyrights • Unique DOI for all articles http://biomedres.us/