Ameloblastic fibroma and ameloblastic fibrosarcoma: a systematic review

Abstract

Purpose

To integrate the available data published to date on ameloblastic fibromas (AF) and ameloblastic fibrosarcomas (AFS) into a comprehensive analysis of their clinical/radiologic features.

Methods

An electronic search was undertaken in July/2017. Eligibility criteria included publications having enough clinical, radiological and histological information to confirm a definite diagnosis.

Results

244 publications (279 central AF tumours, 10 peripheral AF, 103 AFS) were included.

AF and AFS differed significantly with regard to the occurrence of patients' mean age, bone expansion, cortical bone perforation and lesion size. Recurrence rates were: central AF (19.2%), peripheral AF (12.5%), AFS (all lesions, 35%), primary (de novo) AFS (28.8%), secondary AFS (occurring after an AF, 50%). Larger lesions and older patients were more often treated by surgical resections for central AF. Segmental resection resulted in the lowest rate of recurrence for most of the lesion types. AFS treated by segmental resection had a 70.5% lower probability to recur (OR 0.295; p=0.049) than marginal resection. 21.3% of the AFS-patients died due to complications related to the lesion.

Conclusions

Very long follow-up is recommended for AF lesions, due to the risk of recurrence and malignant change into AFS. Segmental resection is the most recommended therapy for AFS.

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