PMC3714812_01
Intraoral view shows buccal and palatal expansion in the left maxillary region and the exophytic ulcerated mass
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F1
Also, the extraction site of the second and third molar was filled with an irregular exophytic ulcerated mass which bled easily on palpation [Figure 1].
Computed tomography scan shows extensive destruction of the left maxillary sinus
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F2
Computed tomography scan showed extension of the lesion medially and vertically to the nasal septal bone and the inferior orbital rim, respectively [Figure 2].
Photomicrographs showing (a) benign-appearing epithelial islands and highly cellular mesenchymal component (H and E, original magnification x100); (b) pleomorphism and scattered bizarre cells in mesenchymal component (H and E, original magnification x100)
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F3
Nuclear hyperchromatism, pleomorphism, and scattered mitotic figures were identified in some areas as well as giant and bizarre cells and the tumor was diagnosed as "ameloblastic fibrosarcoma" accordingly [Figures 3a and b].
Intraoral examination and (a) CT scan evaluation (b) revealed no evidence of recurrence after two years
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F4
At present, after 2 years, the patient is free of any recurrence and in a good health status [Figures 4a and b].