Introduction: Odontogenic tumors cover a wide and diverse spectrum of tumors. Some odontogenic tumors have a varied etiopathogenesis and share a presentation very similar to hybrid odontogenic tumors. Ameloblastic fibro-odontoma is one such tumor. Though the WHO 2017 Classification of Head and Neck tumors continues to support this hypothesis, it is clear, with more than 215 case reports, that it is a tumor that does not feature in the continuum of the spectrum of ameloblastic fibroma ending with ameloblastic fibro-odontoma and odontoma. It, therefore, deems recognition as an independent entity.The ameloblastic fibro-odontoma irrespective of central or peripheral location will show an ameloblastic fibroma like presentation along with a compound or complex composite odontome histologically. It has also been conjectured whether it is a true neoplasm or hamartoma.
Case Report: We report a case of an ameloblastic fibro-odontoma in an eight-year-old boy with a diffuse swelling extraorally in the infraorbitalzygomatic area. Intraoral examination revealed a large 4.5x3 cm soft tissue mass on the right maxillary alveolar area involving primary molars and permanent 1st and 2nd molar region. Radiologic examination revealed a lesion with 32 denticles and destruction of alveolar bone, which showed a histopathologic picture of ameloblastic fibro-odontoma with a composite compound odontoma like pattern.
Conclusion: Our case describes an ameloblastic fibro-odontoma, which presented as a painful mass of the maxilla with compound composite odontome like features supporting the tumor concept and as an independent entity not belonging to the continuum spectrum.

Keywords: Ameloblastic fibro-odontoma, Central, Composite compound odontoma, Dentin, Enamel, Induction, Maxillary posterior quadrant