Report of a rare case of ameloblastic fibro-odontoma of the mandible with >400 odontomas and a related literature review

Introduction: Ameloblastic fibro-odontoma (AFO) is a benign odontogenic tumor of mixed origin. It is often asymptomatic and can be diagnosed by a delayed eruption of a permanent tooth. AFO is often associated with one or more impacted teeth. Observation: The patient in the reported case was a 20-year-old girl, who consulted us because of pain associated with functional impairment in the left mandibular region for approximately 4 years. Intraoral examination demonstrated bud-like lesion at the location of the missing left lower molars. The computed tomography scan showed intralesional calcifications and dental densities. Enucleation was performed under general anesthesia. Excised tissues included two teeth, with their pericoronal bags, and hundreds of microelements isolated or embedded in membranes. Macroscopic examination showed >400 odontomas, and 28 membranous portions containing other odontomas, apart from permanent teeth. Postoperative recovery was satisfactory. Conclusion: It is an extensive odontogenic tumor often associated with an impacted tooth.