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Ameloblastic fibroma, ameloblastic fibro-odontoma, and odontoma

2004; Elsevier BV; Volume: 16; Issue: 3 Linguagem: Inglês

10.1016/j.coms.2004.03.005

1558-1365

Donald M. Cohen, Indraneel Bhattacharyya,

Bone Tumor Diagnosis and Treatments

Ameloblastic fibroma (AF) is a relatively rare true tigators believe that AF and AFO are variations of the mixed tumor in which epithelial and the ectomesenchymal elements are neoplastic. It is characterized by the simultaneous neoplastic proliferation of the mesenchymal and epithelial components without formation of dental hard tissues, namely dentin and enamel. AF and related lesions were defined by the World Health Organization (WHO) in 1992 as ‘‘neoplasms composed of proliferating odontogenic epithelium embedded in a cellular ectomesenchymal tissue that resembles the dental papilla, and with varying degrees of inductive change and dental hard tissue formation’’ [1,2]. This lesion first was reported by Kruse in 1891 [2]. It is believed to arise de novo during odontogenesis, possibly as a result overproduction of the basal lamina without odontogenic differentiation. Lesions composed of similar elements, but in which inductive change has resulted in the deposition of dentin alone or dentin plus enamel, are termed ameloblastic fibrodentinoma (AFD) and ameloblastic fibro-odontoma (AFO), respectively. Controversy exists regarding the belief that these lesions represent separate entities or are the same lesion in a continuum representing different stages of evolution. Cahn and Blum postulated that AF represented the least histologically differentiated lesion that evolves from a moderately differentiated form to AFO to odontoma [3]; however, this concept is not widely accepted, and there may be merit in identifying the differing histologic patterns of the lesions until more experience with their biologic behavior has been accumulated [2,4,5]. Some inves-