Bulletin Board of Oral Pathology

Forum for Clinical and Surgical Oral Pathology Case BBOPF 98-1 The following is a summary of the responses for case BBOP 98-1: 20 Ameloblastic fibroma 10 Ameloblastic fibrosarcoma 3 Ameloblastic fibro-odontoma 2 Ameloblastoma 2 Odontogenic carcinosarcoma 1 ameloblastic fibroma/ameloblastic fibrosarcoma 1 Ameloblastoma 1 Adenomatoid odontogenic tumor The presence of mitotic activity in both, the epithelium and the mesenchyme drew considerable attention. Some individuals thought that despite the increased mitotic activity, the age of the patient militated against the possibility of a malignant lesion. Other respondents noted a high degree of mitotic activity without atypia while others considered minimum atypia in both epithelium and mesenchyme. Still other interpretations favored the presence of malignant features either in the mesenchyme alone or in both, epithelium and mesenchyme. Several of those who thought that this was a benign mixed tumor commented that the possibility of an incipient ameloblastic fibro-odontoma or a complex odontoma could not be ruled out. This contention is a legitimate one, however it is speculative, as no evidence of mineralized dental tissues was observed in the microscopic slides of the lesion. The sign-out diagnosis of the contributor mirrored the opinion of most of the respondents to this case (ameloblastic fibroma) with a comment regarding the unusually high, albeit normal, mitotic activity in both epithelial and mesenchymal components. The follow--up at 2 months revealed that healing is occurring uneventfully. It is hoped that long-term follow-up will be provided and made available to BBOP. If you wish to post a case in the BBOP Forum for Clinical and Surgical Pathology, please contact the managers Alfredo Aguirre and Alan Drinnan. September 11th 1998 [Back to BBOP Home Page]