Maxillary Cystic Ameloblastic Fibroma in an 8-Year-Old Girl: A Case Report Featuring a Rare Histological Variant.

Objective

This report is aimed at outlining the unusual cystic variant of ameloblastic fibroma to facilitate its demarcation from other odontogenic lesions, including dentigerous cysts and cystic ameloblastomas. Case Report: An 8-year-old girl with no significant medical history presented to the oral surgery department with a painless swelling in the right maxillary region, first noticed 1 month ago, which gradually increased in size, accompanied by monocortical expansion of the buccal cortex. Cone beam computed tomography revealed a well-demarcated unilocular low-density lesion in the right posterior maxilla, measuring approximately 3 × 2 cm; the central bony lesion involved an unerupted first permanent molar. Conservative enucleation of the lesion was performed, along with the removal of the impacted tooth. Microscopic examination showed a benign mixed cystic odontogenic tumor, displaying odontogenic epithelial strands with stellate-shaped fibroblasts in a myxoid cell-rich stroma. The epithelial cells were rounded to cuboidal, with no mitotic activity or signs of malignancy. The overall histological image suggested a cystic ameloblastic fibroma.

Conclusion

Clinically and radiographically, cystic ameloblastic fibroma may resemble a dentigerous cyst due to the involvement of an impacted tooth with the lesion. However, these two entities can be clearly histologically differentiated, as the distinctive odontogenic epithelial strands in a myxoid cell-rich stroma that are seen in cystic AF will be absent in a dentigerous cyst.