title: Ameloblastic fibrosarcoma: a rare malignant odontogenic tumor.
abstract: BACKGROUND
  Ameloblastic fibrosarcoma (AFS) is a rare malignant odontogenic tumor. It can arise de novo, however one-third of cases may arise from a recurrent ameloblastic fibroma, in which case they appear to present at an older age.
  
  
  METHODS
  A 16-year-old female presented with one month history of right mandibular mass. Computerized tomography (CT) scan showed a large destructive mass. A biopsy of the mass was performed. Histologically, it consisted of a mixed epithelial-mesenchymal odontogenic neoplasm composed of benign islands of well-differentiated ameloblastic epithelium within a malignant fibrous stroma consisting of spindle cells or fibroblasts with a brisk mitotic activity. The malignant spindle cell proliferation showed positive staining with p-53 and a high proliferation index with ki-67. A diagnosis of AFS was rendered.
  
  
  CONCLUSIONS
  The differential diagnosis includes other odontogenic sarcomas, ameloblastic carcinosarcoma and spindle cell carcinoma. Treatment of choice is wide surgical excision, with long-term follow-up. Postoperative chemotherapy and radiotherapy has been used successfully in a few reported cases. AFS is a locally aggressive malignant tumor, with regional and distant metastases being uncommon.
authors.affiliation: Department of Pathology, St John Hospital & Medical Center, 22101 Moross Rd, Detroit, MI 48236, USA. Electronic address: magilani@hotmail.com.
authors.forename: S M
authors.initials: SM
authors.lastname: Gilani
authors.affiliation: Department of Pathology, St John Hospital & Medical Center, 22101 Moross Rd, Detroit, MI 48236, USA.
authors.forename: A
authors.initials: A
authors.lastname: Raza
authors.affiliation: Department of Pathology, St John Hospital & Medical Center, 22101 Moross Rd, Detroit, MI 48236, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Al-Khafaji
mesh_terms: D000293:Adolescent; D000564:Ameloblastoma / Q000175:diagnosis*; D005260:Female; D005354:Fibrosarcoma / Q000175:diagnosis*; D006801:Humans; D008339:Mandibular Neoplasms / Q000175:diagnosis*
keywords: Ameloblastic fibrosarcoma; Differential diagnosis; Malignant; Odontogenic tumor; Surgical resection