Abstract
Ameloblastic fibroma (AF) is a rare odontogenic neoplasm which is commonly seen in the second decade of life. It is seen most frequently in the mandibular posterior region. AF shows clinical and radiographic resemblance with other commonly occurring odontogenic cyst and tumors. Histopathologically, it shows great resemblance with primitive dental papilla. Immunohistochemistry helps in understanding the nature and proliferative potential of tumor and helps in proper treatment planning. Large lesions and recurrent lesions are treated with segmental resection which can often lead to morbidity, especially in young patients if not managed properly. Herein, we present a case of a large AF in the posterior mandible region in a 21-year-old female patient with significant expansion and erosion of cortical plates and lower border of the mandible with a high Ki67 proliferative index (20%) which was surgically treated by segmental resection and immediate reconstruction by autogenous iliac graft.