Case Report Ameloblastic Fibroma of the Maxilla with Bilateral Presentation: Report of a Rare Case with Review of the Literature Kranti Kiran Reddy Ealla, 1 Vijayabaskar Reddy Basavanapalli, 2 Surekha Reddy Velidandla, 1 Sangameshwar Manikya, 1 Rajesh Ragulakollu, 3 Prasanna M. Danappanavar, 1 and Vijayasree Vennila 4 1 Department of Oral and Maxillofacial Pathology, MNR Dental College and Hospital, Sangareddy, Telangana 502294, India 2 Department of Oral and Maxillofacial Surgery, MNR Dental College and Hospital, Sangareddy, Telangana 502294, India 3 Department of Pedodontics and Preventive Dentistry, KLR’S Lenora Institute of Dental Sciences, Rajahmundry, Andhra Pradesh 533294, India 4 Department of General Pathology, Kamineni Institute of Medical Sciences, Narketpally, Telangana 508254, India Correspondence should be addressed to Kranti Kiran Reddy Ealla; drekkr@yahoo.co.in Received 25 October 2014; Revised 16 December 2014; Accepted 17 December 2014 Academic Editor: Nina L. Shapiro Copyright © 2015 Kranti Kiran Reddy Ealla et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Ameloblastic fbroma (AF) is an uncommon benign odontogenic tumour, with both epithelial and mesenchymal neoplastic proliferation. It occurs most frequently in the posterior region of the mandible, while its occurrence in the maxilla is extremely rare. Tey are usually encountered in children, emphasizing it as an important diagnostic consideration. Herein, we report the frst case of a bilateral maxillary ameloblastic fbroma in a 2-year-old female child patient who presented with a chief complaint of swelling in the right mid facial region. 1. Introduction Ameloblastic fbromas (AFs) are a rare variety of benign odontogenic tumors composed of proliferating odontogenic epithelium embedded in a cellular ectomesenchymal tissue resembling dental papilla [1]. It was frst described by Kruse in 1891 and later classifed as a separate entity by Toma and Goldman in 1946 [2, 3]. Tey are frequently encountered in the posterior mandible with eighty percent cases in the second primary molar or frst permanent molar region [4] and 75% associated with an impacted tooth [5]. Tese tumors are frequently diagnosed between the 1st and 2nd decades of life with 75% of cases being diagnosed before the age of 20 and primarily considered a tumor of childhood and adolescence. Males show a slightly higher prediction than females (M : F = 1.4 : 1) [6]. AFs usually present with a well-defned unilocular or multilocular radiolucencies [7]. Unilocular lesions are pre- dominantly asymptomatic, while the multilocular cases are ofen associated with jaw swelling [8]. However, most of the cases of AFs are encountered as an incidental fnding [9, 10] reiterating their radiographic signifcance in the diferential diagnosis with entities such as dentigerous cyst, ameloblas- toma, odontogenic keratocyst, and ameloblastic fbrosarcoma [11, 12]. Microscopically AFs are composed of both the epithelial and connective tissue components; the later appears to reca- pitulate dental papilla made up of spindled and angular cells with delicate collagen, imparting a myxomatous appearance. Te epithelial component is arranged in thin branching cords or small nests with scanty cytoplasm and basophilic nuclei, while stellate reticulum like cells are common in larger nests. Mitoses are not a characteristic feature of ameloblastic fbroma [13]. In contrast to conventional ameloblastoma, the strands of AFs show double or triple layer of cuboidal cells. Numerous mitotic cells or any atypical mitotic fgure if noticed suggests a malignant entity such as ameloblastic fbrosarcoma (AFS) in the diferential diagnosis [14, 15]. Hindawi Publishing Corporation Case Reports in Pediatrics Volume 2015, Article ID 250713, 4 pages http://dx.doi.org/10.1155/2015/250713