Pediatric Surgical Management of Cystic Ameloblastic Fibroma-Mural Type: A Rare Enigmatic Pathology.

Introduction: Cystic ameloblastic fibroma (CAF) is an uncommon mixed odontogenic tumor. It is rare in children and has a mean age of 15.9 years, commonly seen in the posterior mandibular region. The mural type of CAF is an even rarer subtype, characterized by the presence of cystic spaces lined by tumor cells. Aim: To document the clinical, radiographic, histopathological features, and surgical management of a rare case of cystic ameloblastic fibroma-mural type in an 8-year-old male. The report also aims to provide insights into the diagnosis and treatment of this rare odontogenic tumor in the pediatric population. Case description: We present a case of an 8-year-old male who was diagnosed with a mural type of CAF. The patient presented with facial asymmetry and painless swelling of the right mandible. Diagnosis was confirmed through clinical, radiographic, and histopathological examinations, following which a management plan involving the extraction of affected teeth and the surgical excision of the lesion was performed. A 2-year follow-up showed no recurrence. Conclusion: This report highlights the importance of early diagnosis and prompt management of CAF during the mixed dentition stage. Small lesions may be treated conservatively, but extensive lesions require radical treatment. This case is the first documented instance of CAF in the Asian population and the second occurrence in patients under 10 years old. It outlines the management protocol for CAF in younger patients with mixed dentition, emphasizing the importance of early intervention for positive outcomes. How to cite this article: Gaviappa D, K VK, Augustine D, et al. Pediatric Surgical Management of Cystic Ameloblastic Fibroma-Mural Type: A Rare Enigmatic Pathology. Int J Clin Pediatr Dent 2025;18(7):871-878.