Case Report: Odontogenic carcinosarcoma arising from ameloblastic fibrodentinoma with immunohistochemical profile

Odontogenic carcinosarcoma is an extremely rare mixed malignant odontogenic neoplasm in which both the epithelial and the ectomesenchymal components are cytologically malignant. Owing to the scarcity of the reported cases, the clinical behavior of odontogenic carcinosarcoma remains unexplored. The present work reports a case of odontogenic carcinosarcoma of the mandible with the detailed immuno-histochemical profile. A 28-year-old male presented with a left painless swelling, which recurred after hemimandiblectomy of the lesion. Complete excision of the lesion with a wide safety margin was performed. The histopathological examination revealed cytological malignant features in the follicles as well as in the ectomesenchyme. The immuno-histochemistry demonstrated evidence of epithelial mesenchymal transition. After nine months, the patient demonstrated recurrence in the infra-temporal fossa. Odontogenic carcinosarcoma is a rare highly aggressive malignant odontogenic tumor. Positive expression of smooth muscle actin and vimentin in the epithelial component is a useful aid in the diagnosis of odontogenic carcinosarcoma.