A Case Report on the Diagnosis and Management of a Rare Ameloblastic Fibro-Odontoma in the Anterior Maxilla of a Pediatric Patient

Ameloblastic fibro-odontoma (AFO) is an uncommon, non-cancerous odontogenic tumor that predominantly affects children and young adolescents. This case report details a nine-year-old male patient who presented with a firm swelling accompanied by intermittent serous discharge in the upper right jaw following a fall. Clinical assessment revealed incomplete mouth closure, facial asymmetry, and dentoalveolar extrusion. Radiographic analysis via cone beam computed tomography revealed a heterogeneous radiolucent lesion with focal radiopacities, thinning of the cortical plates, and a minor breach in the nasal floor, indicative of an osteolytic lesion. Differential diagnoses considered included adenomatoid odontogenic tumor and desmoplastic ameloblastoma. Routine blood tests and fine-needle aspiration cytology (FNAC) yielded negative results. The lesion was surgically enucleated under general anesthesia, with preservation of the affected teeth. Histopathological analysis confirmed the diagnosis of AFO, characterized by hyperchromatic columnar ameloblast-like cells, stellate reticulum-like cells, and basophilic dentinoid-like formation within an immature connective tissue stroma. Postoperative recovery was smooth, resulting in notable improvement in facial aesthetics and oral function. AFO is typically located in the posterior mandible, making its occurrence in the anterior maxilla unusual. Conservative surgical management is the recommended strategy and is associated with low recurrence rates. Although malignant transformation has been documented, extensive treatment is generally reserved for cases exhibiting dysplastic changes or aggressive recurrence. This case underscores the importance of early diagnosis, imaging, and histological verification for effective treatment planning. Regular follow-up is crucial to monitor for potential recurrence and to ensure favorable long-term outcomes in patients with AFO.