Clinical management of primary odontogenic sarcoma in the mandible: a case report after WHO nomination

Ameloblastic fibro-odontosarcoma (AFOS) now designated as odontogenic sarcoma is an extremely rare odontogenic tumor, which histologically presents as a biphasic neoplasm with a malignant mesenchymal component plus ameloblastic epithelium. Here we report a 27-year-old Chinese female with the complaint of a painful swelling for half a month in the right mandible. A segmental mandibulectomy, with an immediate mandibular reconstruction using a free vascularized osteocutaneous fibular flap was performed using surgical guide models. Histological analysis revealed a primary odontogenic sarcoma. The postoperative period was uneventful, and no clinical indication of recurrence or metastasis was observed during the 3-year follow-up. No adjuvant therapy was proposed. This is the first odontogenic sarcoma case reported in China after the new World Health Organization classification of odontogenic lesions.

Automated summary

This article reports the first case of odontogenic sarcoma in China after the new World Health Organization classification of odontogenic lesions. The patient presented with painful swelling in the right mandible and underwent surgical treatment with successful recovery and no recurrence during the 3-year follow-up.