1
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Ikawa H, Koto M, Fugo K, Takiyama H, Isozaki T, Shinoto M, Yamada S, Ishikawa H. Carbon-ion radiotherapy for clear cell odontogenic carcinomas. World J Surg Oncol 2024; 22:191. [PMID: 39054550 PMCID: PMC11270857 DOI: 10.1186/s12957-024-03470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 07/16/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic malignant tumor. The standard treatment for CCOC is surgical resection and adjuvant radiotherapy (RT). Radiotherapy is generally considered in inoperable cases. However, there are no reports on definitive RT for CCOC, and the role of RT in patients with inoperable CCOC remains unknown. Therefore, in this report, we present two cases of carbon-ion (C-ion) RT for CCOC. CASE PRESENTATION In case 1, a 73-year-old man with mandibular CCOC presented with recurrence in the inferior temporal fossa after two tumor resections. The tumor was considered inoperable, and C-ion RT (57.6 Gy in 16 fractions) was administered. The tumor remained controlled even after 20 months of C-ion RT; however, the patient died of other causes. In case 2, a 34-year-old man with maxillary CCOC presented with recurrence in the left sinonasal region after two tumor resections. The tumor was considered inoperable, and C-ion RT (64 Gy in 16 fractions) was administered. However, recurrence was observed in the irradiated field 19 months after the treatment. Subsequently, C-ion RT (64 Gy in 16 fractions) was repeated for the recurrent tumors. Seven years and 6 months after the initial irradiation, the tumor remains controlled, and the patient is alive without any unexpected serious adverse events. CONCLUSION C-ion RT may be an effective treatment option for patients with inoperable CCOC.
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Affiliation(s)
- Hiroaki Ikawa
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan.
| | - Masashi Koto
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan
| | - Kazunori Fugo
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan
| | - Hirotoshi Takiyama
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan
| | - Tetsuro Isozaki
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan
| | - Makoto Shinoto
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan
| | - Shigeru Yamada
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan
| | - Hitoshi Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba, 263-8555, Japan
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2
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Robertson IJ, Robbins QC, Li PC. Case of metastatic clear cell odontogenic carcinoma with response to chemoimmunotherapy. BMJ Case Rep 2024; 17:e259568. [PMID: 38684356 PMCID: PMC11146348 DOI: 10.1136/bcr-2023-259568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Our patient initially presented with 6 months of left jaw pain and gingival bleeding, leading to the discovery of a radiolucent left maxillary mass on dental evaluation. A biopsy confirmed clear cell odontogenic carcinoma, and the patient was treated with definitive surgery and radiation for localised disease. Unfortunately, the patient was found to have pulmonary metastases 3 months after initial management and was subsequently treated with a combination of cytotoxic chemotherapy and immunotherapy with a partial response. To our knowledge, this is the first case demonstrating the successful use of chemoimmunotherapy in metastatic clear cell odontogenic carcinoma.
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Affiliation(s)
- Ian J Robertson
- Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Quinn C Robbins
- Oral and Maxillofacial Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Peter C Li
- Hematology/Oncology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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3
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Tomar K, Vasanthanarayanan R, Roy ID, Rangan M. Clear Cell Odontogenic Carcinoma: A Rare JAW Tumor-A Case Report and Literature Review. J Maxillofac Oral Surg 2024; 23:174-179. [PMID: 38312974 PMCID: PMC10830959 DOI: 10.1007/s12663-023-01904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/16/2023] [Indexed: 04/03/2023] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare epithelial malignant odontogenic tumor of the jaw with a distinct histology and deceptive behavior. As the clinical presentation is often misleading, the contribution of biopsy, molecular biology, immunohistochemistry and cytogenetics are essential in the diagnostic process. This article describes the presentation of an aymptomatic, painless swelling in the lower jaw of a 63 yrs old female, who was initially diagnosed as an ameloblastoma, taken up for segmental resection, subsequently histopathologically diagnosed as a case of clear cell odontogenic carcinoma and later managed with chemotherapy. Current management protocols and presentation of CCOC have also been reviewed.
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Affiliation(s)
- Kapil Tomar
- Division of Oral and Maxillofacial Surgery, AFMC, Pune, India
| | - R. Vasanthanarayanan
- Division of Oral and Maxillofacial Surgery, AFMC, Pune, India
- Department of Dental Surgery & Oral Health Sciences, Division of Oral and Maxillofacial Surgery, Armed Forces Medical College, Solapur Road, Pune, Maharashtra 411040 India
| | - I. D. Roy
- Division of Oral and Maxillofacial Surgery, AFMC, Pune, India
| | - Mohan Rangan
- Division of Oral and Maxillofacial Surgery, AFMC, Pune, India
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4
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Penafort PVM, Roza ALOC, Kussaba ST, de Brot Andrade L, Pinto CAL, Vargas PA. Exuberant clear cell odontogenic carcinoma of the mandible harboring EWSR1 rearrangement: Report of a rare case and a literature review. Oral Oncol 2023; 143:106462. [PMID: 37331036 DOI: 10.1016/j.oraloncology.2023.106462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/11/2023] [Indexed: 06/20/2023]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic tumour (MOT) that mainly affects the mandible, with a slight female predominance in adult patients. In this study, we described an exuberant CCOC in mandible of a 22-year-female patient. On radiographic examination, a radiolucent lesion in the region of tooth 36 to 44 with tooth displacement and alveolar cortical resorption was observed. Histopathological study revealed a malignant neoplasm of the odontogenic epithelium, composed of PAS-positive clear cells and immunoreactivity for CK5, CK7, CK19, p63. The Ki-67 index was low (<10 %). Fluorescent in situ hybridization revealed EWSR1 gene rearrangement. The diagnosis of CCOC was established and the patient was referred for surgical treatment.
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Affiliation(s)
| | | | | | | | | | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil.
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5
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Labrador AJP, Marin NRG, Valdez LHM, Valentina MP, Sanchez KBT, Ibazetta KAR, Johan B, Cesar AV, Wright JM. Clear Cell Odontogenic Carcinoma a Systematic Review. Head Neck Pathol 2021; 16:838-848. [PMID: 34618301 PMCID: PMC9424403 DOI: 10.1007/s12105-021-01383-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/24/2021] [Indexed: 02/07/2023]
Abstract
Clear cell Odontogenic Carcinoma (CCOC) is an uncommon malignant odontogenic tumor (MOT). It is the fifth most common MOT. A systematic review is presented of reported cases, case series and retrospective studies of CCOC, to determine trends in presentation, diagnostic features, treatment, and patient outcome. Searches of detailed databases were carried out to identify papers reporting CCOC. The variables were demographics, patient symptoms, tumor location, histopathological findings, immunohistochemical studies, treatment, follow-up, and recurrence. 117 cases were identified; CCOC was most frequently seen in mature females 65% (n = 76). The total average age was 55.4 with a range from 17 to 89 years, for females 56.4 and males 53.6 years. The mean size was 3.41 cm. The most common location was in the mandibular body 36.2% (n = 42), followed by the anterior mandible 23.3% (n = 27). The most common clinical presentation was a swelling 80.4% (n = 74), and the main symptom was pain 41.3% (n = 31), followed by painless lesion 24% (n = 18). The most common Immunohistochemistry positive expression was CK19, EMA, and CEA, and for special staining periodic acid Shiff (PAS); 97% of cases were treated surgically. The average follow-up was 30.3 months, and recurrence was reported in 52.4% of the cases. Conclusion: CCOC shows a strong predilection for the body and anterior mandible, and females are more frequently affected. CCOCs can be painful and the principle clinical sign is swelling, CCOCs can metastasize, and the prognosis is fair.
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Affiliation(s)
| | | | | | - Martinez P. Valentina
- grid.442123.20000 0001 1940 3465Universidad de Cuenca Facultad de Odontologia, Cuenca, Ecuador
| | | | | | | | - Abad Villacrez Cesar
- grid.441720.40000 0001 0573 4474Universidad Señor de SIPAN Dental School, Chiclayo, Peru
| | - John M. Wright
- grid.264756.40000 0004 4687 2082Department of Diagnostic Sciences, Texas A&M University College of Dentistry, 3302, Gaston Ave, Dallas, TX 75246 USA
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6
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Marinho EB, Alves APNN, Pereira-Filho FJF, Ferreira-Junior AEC, Mota MRL, Sousa FB. Rare clear cell odontogenic carcinoma associated with impacted tooth in a young patient: case report and literature review. Oral Maxillofac Surg 2021; 26:491-503. [PMID: 34542774 DOI: 10.1007/s10006-021-01006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic tumor. It is characterized by showing, on histopathological examination, clusters of vacuolated and clear tumor cells with epithelial differentiation surrounded by fibrocollagenous stroma and fibroblasts. The present study presents a rare clinical case of mandibular CCOC associated with an impacted tooth in a 26-year-old woman surgically treated with mandibulectomy and reconstruction with iliac crest bone graft. The patient has been followed up for 22 months without signs of recurrence. A search for case report/case series was carried out in the PUBMED database, as well as in the references of relevant previously published literature reviews. Ninety-six publications were identified, totaling 136 distinct cases reported. Female sex was the most affected (63.1%) with 63.3% of cases occurring in patients in the fifth, sixth, or seventh decades of life. The mandible was more affected than the maxilla (74.2%). Association of CCOC with impacted teeth was found in 2.4% of cases, thus rendering it a rare occurrence. The present case report corroborates the results of the survey regarding sex and anatomical location of the tumor; however, it contradicts the findings regarding age predilection. The case described is the fourth known occurrence of tooth impaction associated with the tumor and the first in a female. In conclusion, CCOC should be considered, as well as other malignancies, as a possible diagnosis of maxillary or mandibular intraosseous lesions even in unusual circumstances such as in association with impacted teeth and in young patients.
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Affiliation(s)
- Erasmo Bernardo Marinho
- Departament of Dental Clinic, Federal University of Ceara, Fortaleza, Ceará, Brazil. .,Dental Specialties Center, CEO Municipal de Caucaia, Caucaia, Ceará, Brazil.
| | | | | | | | | | - Fabricio Bitu Sousa
- Departament of Dental Clinic, Federal University of Ceara, Fortaleza, Ceará, Brazil.,School of Dentistry, Christus University Center - UNICHRISTUS, Fortaleza, Ceará, Brazil
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7
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Yang JY, Hwang DS, Kim UK. Sequential treatment from mandibulectomy to reconstruction on mandibular oral cancer - Case review II: mandibular anterior and the floor of the mouth lesion of basaloid squamous cell carcinoma and clear cell odontogenic carcinoma. J Korean Assoc Oral Maxillofac Surg 2021; 47:216-223. [PMID: 34187962 PMCID: PMC8249190 DOI: 10.5125/jkaoms.2021.47.3.216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/07/2020] [Accepted: 12/11/2020] [Indexed: 11/23/2022] Open
Abstract
Preoperative patient analysis for oral cancer involves multiple considerations that are based on multiple factors; these include TNM stages, histopathologic findings, and adjacent anatomical structures. Once the decision is made to excise the lesion, the margin of dissection and its extent should be considered along with the best form of reconstruction and airway management. Treatment methods include surgical resection, radiotherapy, and chemotherapy. Although the combined method of treatment is controversial, surgical resection is considered predominantly, and immediate reconstruction after surgical resection follows. The choice of treatment is dictated by the anticipated functional and esthetic results of treatment and also by the availability of a surgeon with the required expertise. Segmental mandibulectomy with primary reconstruction has been shown to have advantages in both functional and esthetic results. A 52-year-old male patient with basaloid squamous cell carcinoma of the floor of the mouth, and the anterior portion of the mandible was treated with surgical procedures that included segmental mandibulectomy with both supraomohyoid neck dissection (SOHND) at Levels I–III and mandible reconstruction with a left fibula free flap. A 55-year-old male patient with clear cell odontogenic carcinoma of the oral cavity underwent segmental mandibulectomy with both SOHND at Levels I–III and mandible reconstruction with a left fibula free flap. The purpose of this study was to review the anatomic and functional results of patients after immediate reconstruction with a fibula free flap following resection of carcinoma in the anterior portion of the mandible and floor of the mouth.
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Affiliation(s)
- Jae-Young Yang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Dae-Seok Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Uk-Kyu Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
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8
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Guastaldi FPS, Faquin WC, Gootkind F, Hashemi S, August M, Iafrate AJ, Rivera MN, Kaban LB, Jaquinet A, Troulis MJ. Clear cell odontogenic carcinoma: a rare jaw tumor. A summary of 107 reported cases. Int J Oral Maxillofac Surg 2019; 48:1405-1410. [PMID: 31227275 DOI: 10.1016/j.ijom.2019.05.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/22/2019] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to summarize the currently published cases of clear cell odontogenic carcinoma (CCOC). The PubMed and Springer databases were used to collect available reports, searching for 'clear cell odontogenic carcinoma', 'CCOC', or 'clear cell ameloblastoma'. The search resulted in 75 reports detailing 107 cases between 1985 and 2018. Clinically the tumor manifests as a swelling in the posterior mandible (n=46), anterior mandible (n=33), and maxilla (n=28). Radiological analysis of 85 cases typically showed a poorly defined expansive radiolucency (n=83). Of the 70 patients with symptoms reported, 44 specified a swelling, 11 tooth mobility, seven gingival/periodontal issues, five numbness, and three decreased jaw opening. One patient presented with a neck mass. The duration of symptoms prior to seeking care was specified for 52 patients: 2 months to 1 year for 34 patients, 1-2 years for seven, 2-4 years for two, 4-7 years for six, and 7-12 years for three. The incidence of recurrence appeared to be 38 of the 88 cases where recurrence was reported. CCOC can be distinguished from other oral cancers by its distinctive histology and immunohistochemical characteristics and less aggressive behavior. Currently, treatment should be early and aggressive resection with clear surgical margins and long-term follow-up. The overall goal is to collect a cohort of patients.
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Affiliation(s)
- F P S Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - W C Faquin
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - F Gootkind
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - S Hashemi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - M August
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - A J Iafrate
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - M N Rivera
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - L B Kaban
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | | | - M J Troulis
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA.
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9
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Park JC, Kim SW, Baek YJ, Lee HG, Ryu MH, Hwang DS, Kim UK. Misdiagnosis of ameloblastoma in a patient with clear cell odontogenic carcinoma: a case report. J Korean Assoc Oral Maxillofac Surg 2019; 45:116-120. [PMID: 31106140 PMCID: PMC6502756 DOI: 10.5125/jkaoms.2019.45.2.116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/13/2017] [Accepted: 11/22/2017] [Indexed: 12/02/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC), a rare tumor in the head and neck region, displays comparable properties with other tumors clinically and pathologically. In consequence, an incorrect diagnosis may be established. A 51-year-old male patient who was admitted to the Department of Oral and Maxillofacial Surgery at Pusan National University Dental Hospital was initially diagnosed with ameloblastoma via incisional biopsy. However, the excised mass of the patient was observed to manifest histopathological characteristics of ameloblastic carcinoma. The lesion was ultimately diagnosed as clear cell odontogenic carcinoma by the Department of Oral Pathology of Pusan National Dental University. Therefore, segmental mandibulectomy and bilateral neck dissection were performed, followed by reconstruction with fibula free flap and reconstruction plate. Concomitant chemotherapy radiotherapy was not necessary. The patient has been followed up, and no recurrence has occurred 6 months after surgery.
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Affiliation(s)
- Jong-Cheol Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Seong-Won Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Young-Jae Baek
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Hyeong-Geun Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Mi-Heon Ryu
- Department of Oral Pathology, BK21 Plus Project, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Dae-Seok Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Uk-Kyu Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
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10
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Slootweg PJ, Odell EW, Baumhoer D, Carlos R, Hunter KD, Taylor AM, Richardson MS, Slater L, Speight PM, Wright J, Thompson LDR. Data Set for the Reporting of Malignant Odontogenic Tumors: Explanations and Recommendations of the Guidelines From the International Collaboration on Cancer Reporting. Arch Pathol Lab Med 2018; 143:587-592. [PMID: 30500289 DOI: 10.5858/arpa.2018-0417-sa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A data set has been developed for the reporting of excisional biopsies and resection specimens for malignant odontogenic tumors by members of an expert panel working on behalf of the International Collaboration on Cancer Reporting, an international organization established to unify and standardize reporting of cancers. Odontogenic tumors are rare, which limits evidence-based support for designing a scientifically sound data set for reporting them. Thus, the selection of reportable elements within the data set and considering them as either core or noncore is principally based on evidence from malignancies affecting other organ systems, limited case series, expert opinions, and/or anecdotal reports. Nevertheless, this data set serves as the initial step toward standardized reporting on malignant odontogenic tumors that should evolve over time as more evidence becomes available and functions as a prompt for further research to provide such evidence.
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Affiliation(s)
- Pieter J Slootweg
- From the Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands (Dr Slootweg); Head and Neck Pathology, King's College London, United Kingdom (Dr Odell); Institute of Pathology, University Hospital Basel, Basel, Switzerland (Dr Baumhoer); Centro Clínico de Cabeza y Cuello, Pathology Division, Guatemala City, Guatemala (Dr Carlos); Oral and Maxillofacial Medicine, Surgery and Pathology (Dr Hunter) and the Department of Oral Pathology (Dr Speight), University of Sheffield, Sheffield, United Kingdom; Health Care Department, Universidad Autonoma Metropolitana Xochimilco, Mexico City, Mexico (Dr Mosqueda Taylor); the Department of Pathology & Laboratory Medicine, Medical University of South Carolina, Charleston (Dr Richardson); Scripps Oral Pathology Service, San Diego, California (Dr Slater); the Department of Diagnostic Sciences, Texas A&M College of Dentistry, Dallas (Dr Wright); and the Department of Pathology, Southern California Permanente Medical Group, Woodland Hills (Dr Thompson)
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11
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Ferreira S, Faverani LP, Santos GMD, Martins EP, Garcia Júnior IR. Clear cell odontogenic carcinoma of the mandible: a treatment strategy. J Appl Oral Sci 2018; 26:e20160645. [PMID: 29340482 PMCID: PMC5777409 DOI: 10.1590/1678-7757-2016-0645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/08/2017] [Indexed: 11/22/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine. Incisional biopsy analysis indicated a diagnosis of CCOC. The treatment proposed was segmental resection of the mandible with a safety margin. After six months without recurrence, definitive mandibular reconstruction was performed using an iliac crest graft, followed by rehabilitation with implant-supported denture after five months. After three years of post-resection follow-up, the patient has shown no evidence of recurrence or metastasis. She continues to be under follow-up. To conclude, CCOC must be considered a malignant tumor with aggressive behavior. Previous studies have shown that resection with free margins is a treatment with a lower rate of recurrence. Nevertheless, long-term follow-up is necessary for such patients.
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Affiliation(s)
- Sabrina Ferreira
- Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, SP, Brasil
| | - Leonardo Perez Faverani
- Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, SP, Brasil
| | - Gabriel Mulinari Dos Santos
- Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, SP, Brasil
| | | | - Idelmo Rangel Garcia Júnior
- Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, SP, Brasil
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12
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Wright JM, Soluk Tekkesin M. Odontogenic tumors: where are we in 2017 ? J Istanb Univ Fac Dent 2017; 51:S10-S30. [PMID: 29354306 PMCID: PMC5750825 DOI: 10.17096/jiufd.52886] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/04/2017] [Indexed: 11/30/2022] Open
Abstract
Odontogenic tumors are a heterogeneous group of
lesions of diverse clinical behavior and histopathologic
types, ranging from hamartomatous lesions to malignancy.
Because odontogenic tumors arise from the tissues which
make our teeth, they are unique to the jaws, and by extension
almost unique to dentistry. Odontogenic tumors, as in normal
odontogenesis, are capable of inductive interactions between
odontogenic ectomesenchyme and epithelium, and the
classification of odontogenic tumors is essentially based
on this interaction. The last update of these tumors was
published in early 2017. According to this classification,
benign odontogenic tumors are classified as follows:
Epithelial, mesenchymal (ectomesenchymal), or mixed
depending on which component of the tooth germ gives
rise to the neoplasm. Malignant odontogenic tumors are
quite rare and named similarly according to whether the
epithelial or mesenchymal or both components is malignant.
The goal of this review is to discuss the updated changes to
odontogenic tumors and to review the more common types
with clinical and radiological illustrations.
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Affiliation(s)
- John M Wright
- Department of Diagnostic Sciences, School of Dentistry, Texas A&M University, Dallas, TX USA
| | - Merva Soluk Tekkesin
- Department of Tumor Pathology, Institute of Oncology, Istanbul University, Istanbul Turkey
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13
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Clear cell odontogenic carcinoma. A review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:363-370. [DOI: 10.1016/j.jormas.2017.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/27/2017] [Accepted: 08/04/2017] [Indexed: 11/21/2022]
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14
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RAHPEYMA A, KHAJEHAHMADI S, HASHEMI EM. Perinöral İnvazyon Gösteren Alt Çene Berrak Hücreli Odontojenik Karsinom: Bir Derleme. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.307315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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15
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Abstract
This article reviews a myriad of common and uncommon odontogenic cysts and tumors. The clinical presentation, gross and microscopic features, differential diagnosis, prognosis, and diagnostic pitfalls are addressed for inflammatory cysts (periapical cyst, mandibular infected buccal cyst/paradental cyst), developmental cysts (dentigerous, lateral periodontal, glandular odontogenic, orthokeratinized odontogenic cyst), benign tumors (keratocystic odontogenic tumor, ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, ameloblastic fibroma and fibroodontoma, odontoma, squamous odontogenic tumor, calcifying cystic odontogenic tumor, primordial odontogenic tumor, central odontogenic fibroma, and odontogenic myxomas), and malignant tumors (clear cell odontogenic carcinoma, ameloblastic carcinoma, ameloblastic fibrosarcoma).
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Affiliation(s)
- Elizabeth Ann Bilodeau
- Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, G-135 Salk Hall, 3501 Terrace Street, Pittsburgh, PA 15261, USA.
| | - Bobby M Collins
- Department of Surgical Science, East Carolina University School of Dental Medicine, 1851 MacGregor Downs Road, Greenville, NC 27834, USA
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16
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Farooq S, Nadaf A, Beigh A, Khuroo M, Bhat N, Nazir N. Metastatic lesions: A diagnostic dilemma-retrospective study, Srinagar, Jammu and Kashmir, India. J Oral Maxillofac Pathol 2016; 20:256-60. [PMID: 27601819 PMCID: PMC4989557 DOI: 10.4103/0973-029x.185925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Renal clear cell carcinoma (RCC) accounts for about 3% of adult malignancies and about 90% of neoplasms of the kidney. It is most common in men aged 50 to 60 years old. RCC has different manifestations, including metastasis in uncommon sites and paraneoplastic syndromes. AIMS To evaluate the clinicopathological pattern of RCC. MATERIALS AND METHODS This study was conducted in the Department of Pathology, Government Medical College, Srinagar. It was a retrospective study done over a period of 5 years, November 2009 to November 2014. RESULTS The study was done to evaluate the clinicopathological pattern of 6 cases of RCC diagnosed at a tertiary care hospital. All patients were males, presenting with submandibular swellings without any other symptom. Radiological and histopathological examination proved the lesion as metastasis of renal cell carcinoma to the mandible. CONCLUSION Being a rare presentation in the head and neck region, metastatic renal cell carcinoma needs to be considered in the differential diagnosis of submandibular swellings even in patients younger than 40 years.
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Affiliation(s)
- Summyia Farooq
- Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India
| | - Afreen Nadaf
- Department of Oral Pathology, GDC and H, Srinagar, Jammu and Kashmir, India
| | - Ambreen Beigh
- Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India
| | - Mehnaaz Khuroo
- Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India
| | - Nazia Bhat
- Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India
| | - Naila Nazir
- Department of Pathology, GMC, Srinagar, Jammu and Kashmir, India
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17
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Jain A, Shetty DC, Juneja S, Narwal N. Molecular Characterization of Clear Cell Lesions of Head and Neck. J Clin Diagn Res 2016; 10:ZE18-23. [PMID: 27437379 DOI: 10.7860/jcdr/2016/14394.7867] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 12/11/2015] [Indexed: 11/24/2022]
Abstract
The salivary glands, oral mucosa and jaws constitute a group of lesions which are heterogeneous in nature and are odontogenic, salivary or metastatic in origin. This group of tumours is termed as Clear Cell Tumours. Fixation artifacts are one of the most important reasons for the cell to appear clear but clearing of cells may also result from cytoplasmic accumulation of water, presence of glycogen within the cell, intermediate filaments, immature zymogen granules, or a paucity of cellular organelles. Clear cell Odontogenic neoplasms predominantly include odontogenic carcinoma, ameloblastoma and calcifying epithelial odontogenic tumour. Clear cell tumours of salivary gland origin are almost invariably malignant in nature but they do include two benign lesions. Very frequently, surgical pathologist encounters clear cells in many malignant neoplasms, the nature and sources of which are undetermined on the basis of conventional histopathology. This review will selectively discuss the clinicopathological features of neoplasms which at times may pose a diagnostic challenge and dilemma due to clear cell changes.
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Affiliation(s)
- Anshi Jain
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, I.T.S. Centre for Dental Studies and Research , Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Devi Charan Shetty
- Professor and Head, Department of Oral and Maxillofacial Pathology, I.T.S. Centre for Dental Studies and Research , Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Saurabh Juneja
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, I.T.S. Centre for Dental Studies and Research , Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Narwal
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, I.T.S. Centre for Dental Studies and Research , Murad Nagar, Ghaziabad, Uttar Pradesh, India
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18
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Abstract
This article presents various odontogenic cysts and tumors, including periapical cysts, dentigerous cysts, odontogenic keratocysts, orthokeratinized odontogenic cysts, lateral periodontal cysts, glandular odontogenic cysts, ameloblastomas, clear cell odontogenic carcinomas, adenomatoid odontogenic tumors, calcifying epithelial odontogenic tumors, squamous odontogenic tumors, ameloblastic fibromas, ameloblastic fibro-odontomas, odontomas, calcifying cystic odontogenic tumors, and odontogenic myxomas. The authors provide an overview of these cysts and tumors, with microsopic features, gross features, differential diagnosis, prognosis, and potential diagnostic pitfalls.
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Affiliation(s)
- Angela C Chi
- Division of Oral Pathology, Department of Stomatology, College of Dental Medicine, Medical University of South Carolina, MSC 507, 173 Ashley Avenue, Charleston, SC 29425, USA
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Loyola AM, Cardoso SV, de Faria PR, Servato JPS, Barbosa de Paulo LF, Eisenberg ALA, Dias FL, Gomes CC, Gomez RS. Clear cell odontogenic carcinoma: report of 7 new cases and systematic review of the current knowledge. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:483-96. [PMID: 26232924 DOI: 10.1016/j.oooo.2015.06.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The goal of this study is to describe 7 cases of clear cell odontogenic carcinoma among a Brazilian population and compare these data with a systematic review of the English-language literature. STUDY DESIGN Descriptive statististics were used to compare the clinicopathologic data gathered retrospectively with those compiled from a review. Tumor sections were immunostained for Ki-67, p16, p53, and cytokeratins (CKs) 7, 8, 14, 18, and 19. Log-rank tests were performed for survival analysis. RESULTS Most cases occurred in the posterior mandible (5/7, 71.4%), and recurrence was diagnosed in all treated patients. Metastatic disease occurred in 2 patients (28.6%). Tumors were focally positive for CKs 7, 8, 14, and 18 and diffusely positive for CK19, p53, and p16. The mean number of Ki-67-positive cells was 35.2 cells/high-power field. Our systematic review provided evidence that tumor size (P = .046), histologic pattern (P = .034), regional metastasis (P = .001), distant metastasis (P = .001), and local recurrence (P = .05) were of significant prognostic value. CONCLUSIONS This study has contributed to improved characterization of clear cell odontogenic carcinoma, which is an aggressive odontogenic malignant neoplasm diagnosed mainly in the posterior mandible of middle-aged women and typically at an advanced stage. Radical surgical procedures remain the gold standard treatment.
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Affiliation(s)
- Adriano Mota Loyola
- Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia, Uberlândia (MG), Brazil.
| | - Sergio Vitorino Cardoso
- Department of Morphology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia (MG), Brazil
| | - Paulo Rogério de Faria
- Department of Morphology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia (MG), Brazil
| | - João Paulo Silva Servato
- Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia, Uberlândia (MG), Brazil
| | | | | | - Fernando Luiz Dias
- Division of Head and Neck Surgery, Brazilian National Institute of Cancer, Rio de Janeiro (RJ), Brazil
| | | | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
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20
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Harbhajanka A, Lamzabi I, Jain R, Gattuso P, Kluskens L. Cytomorphology and immunohistochemistry of a recurrent clear cell odontogenic carcinoma with molecular analysis: A case report with review of literature. Diagn Cytopathol 2015; 43:743-6. [PMID: 26061809 DOI: 10.1002/dc.23297] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/27/2015] [Accepted: 04/09/2015] [Indexed: 11/09/2022]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare, odontogenic tumor of the jaws with mandibular involvement usually present in sixth decade of life with female preponderance. It is classified as a malignant tumor of odontogenic origin in 2005 by the World Health Organization because of its aggressive and destructive growth capacity and potential to metastasize. It needs to be distinguished from other primary and metastatic clear cell tumors of the oral and maxillofacial region. Recently, CCOCs have been noted to harbor a Ewing sarcoma breakpoint region 1 gene RNA-binding protein 1 (EWSR1) and activating transcription factor (ATF) gene translocation. To date, cytologic features of only one case have been reported in the literature. We report an additional case of 55-year-old woman with enlarging mass in the left mandible. This report describes cytologic and immunohistochemical features of CCOC with positive EWSR1 gene rearrangements by fluorescence in situ hybridization (FISH). As diagnosis of CCOC is challenging on fine-needle aspiration, immunohistochemistry and FISH analysis are very useful diagnostic tool in clear cell lesions of mandible.
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Affiliation(s)
- Aparna Harbhajanka
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Ihab Lamzabi
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Richa Jain
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Larry Kluskens
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
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21
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Ginat DT, Villaflor V, Cipriani NA. Oral Cavity Clear Cell Odontogenic Carcinoma. Head Neck Pathol 2015; 10:217-20. [PMID: 25994920 PMCID: PMC4838979 DOI: 10.1007/s12105-015-0635-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 05/12/2015] [Indexed: 11/29/2022]
Abstract
A case of clear cell odontogenic carcinoma of the oral cavity is described in this sine qua non radiology-pathology correlation article. CT demonstrated a solid and cystic mass arising from the mandible. Histology demonstrated variably-sized nests of clear to pale eosinophilic cells with occasional central necrosis embedded in a hyalinized to fibrocellular stroma. The specimen was also positive for the characteristic rearrangement of the EWSR1 (22q12) locus in 93.5% of interphase cells.
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Affiliation(s)
- Daniel Thomas Ginat
- />Department of Radiology, Pritzker School of Medicine, University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637 USA
| | - Victoria Villaflor
- />Department of Medicine, Section of Hematology Oncology, Pritzker School of Medicine, University of Chicago, Chicago, IL USA
| | - Nicole A. Cipriani
- />Department of Pathology, Pritzker School of Medicine, University of Chicago, Chicago, IL USA
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22
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Ganvir SM, Gajbhiye NY. An unusual presentation of clear cell odontogenic carcinoma in mandibular anterior region. J Oral Maxillofac Pathol 2015; 18:442-8. [PMID: 25949004 PMCID: PMC4409194 DOI: 10.4103/0973-029x.151344] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 01/10/2015] [Indexed: 11/16/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare, potentially aggressive odontogenic epithelial tumor with tendency for recurrence. It was first described as a clinicopathological entity in 1985 and to date only 73 cases has been reported in English literature. A case of CCOC in 64-year-old male patient in mandibular anterior region is presented which when recurred in soft tissue 5 years after wide surgical resection of mandible, revealed a biphasic pattern as against monophasic pattern of primary neoplasm and was unusually associated with primary squamous cell carcinoma, suggestive of hybrid tumor.
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Affiliation(s)
- Sindhu M Ganvir
- Department of Oral Pathology, Government Dental College and Hospital Nagpur, Maharashtra, India
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23
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Krishnamurthy A, Ramshankar V, Majhi U. Clear cell odontogenic carcinoma of the mandible and temporomandibuar joint with cervical lymph nodal metastasis. Natl J Maxillofac Surg 2015; 5:221-3. [PMID: 25937741 PMCID: PMC4405972 DOI: 10.4103/0975-5950.154842] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare aggressive tumor that has the ability to invade locally as well as cause regional and distant metastasis. The etiology of this neoplasm remains poorly understood and the diagnosis of CCOC is done by exclusion of other clear cell tumors. To date, approximately 75 cases of CCOC have been described in the English literature, all involving a single jaw. The majority of cases have been reported to arise from the mandible, the maxilla is less frequently involved, and no case had involvement of the temporomandibuar joint. Lymph node metastasis at initial presentation is reportedly rare (<10%). We describe possibly the first case of CCOC in a 50-year-old woman with involvement of the mandible and the temporomandibuar joint along with cervical lymph nodal metastasis. We share our experiences and challenges in the management of this unusual tumor.
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Affiliation(s)
- Arvind Krishnamurthy
- Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
| | | | - Urmila Majhi
- Department of Pathology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
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24
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Prakash AR, Sairam V, Srinivas Reddy P. Clear cell odontogenic carcinoma-a rare case report. J Maxillofac Oral Surg 2015; 14:60-3. [PMID: 25838670 DOI: 10.1007/s12663-011-0296-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 09/26/2011] [Indexed: 10/17/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumour with female predilection occurring in the anterior region of the mandible with peak age incidence of 5th and 7th decade of life. Here we report a case occurred in the posterior mandible of a 42 year old male patient which highlights the clinicopathologic features of CCOC that were confirmed by histopathologic examination. We add up yet another case of CCOC to the published literature.
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Affiliation(s)
- A Ravi Prakash
- Department of Oral and Maxillofacial Pathology, G. Pulla Reddy Dental College & Hospital, Nandhyal Road, Kurnool, 518002 Andhra Pradesh India
| | - V Sairam
- Department of Oral Medicine & Radiology, G. Pulla Reddy Dental College & Hospital, Kurnool, 518002 India
| | - P Srinivas Reddy
- Department of Oral Maxillofacial Surgery, G. Pulla Reddy Dental College & Hospital, Kurnool, 518002 India
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25
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Richardson MS, Muller S. Malignant odontogenic tumors: an update on selected tumors. Head Neck Pathol 2014; 8:411-20. [PMID: 25409848 PMCID: PMC4245406 DOI: 10.1007/s12105-014-0584-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 11/01/2014] [Indexed: 01/10/2023]
Abstract
This is an update on selected odontogenic malignancies. The article deals with aspects of recognized odontogenic carcinomas, odontogenic sarcoma and a yet unrecognized entity, sclerosing odontogenic carcinoma. Odontogenic malignancies are exceedingly rare, complicating a thorough understanding of the biologic behavior, reproducible standardized diagnostic criteria, appropriate classification and clinical management. Without the knowledge of the tumor's biologic behavior, adequate clinical management is difficult and patient outcomes uncertain. The histopathologic features are emphasized as well as the more recent biomarker findings. These recent advances may facilitate further understanding of this group of malignancies and provide useful stratification to guide patient management.
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Affiliation(s)
- Mary S Richardson
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 165 Ashley Ave, EH 303D4, Charleston, SC, 29425, USA,
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26
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Kim M, Cho E, Kim JY, Kim HS, Nam W. Clear cell odontogenic carcinoma mimicking a cystic lesion: a case of misdiagnosis. J Korean Assoc Oral Maxillofac Surg 2014; 40:199-203. [PMID: 25247151 PMCID: PMC4170665 DOI: 10.5125/jkaoms.2014.40.4.199] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 07/10/2014] [Accepted: 07/29/2014] [Indexed: 11/07/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare jaw tumor that was classified as a malignant tumor of odontogenic origin in 2005 by the World Health Organization because of its aggressive and destructive growth capacity and metastasis to the lungs and lymph nodes. We report a case of a 66-year-old female who had swelling, incision and drainage history and a well-defined unicystic radiolucent lesion that was comparable to a cystic lesion. At first, the patient received decompression, and the lesion size decreased. Three months after decompression, cyst enucleation was performed. The pathologic result indicated that the lesion was CCOC. In this report we emphasize that patients with painful cystic lesions in addition to jaw enlargement and loosening teeth should be considered for the possibility of malignancy.
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Affiliation(s)
- Minkyu Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Eunae Cho
- Department of Oral Pathology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyun Sil Kim
- Department of Oral Pathology, College of Dentistry, Yonsei University, Seoul, Korea
- Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
- Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
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27
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Kalsi AS, Williams SP, Shah KA, Fasanmade A. Clear cell odontogenic carcinoma: a rare neoplasm of the maxillary bone. J Oral Maxillofac Surg 2013; 72:935-8. [PMID: 24359996 DOI: 10.1016/j.joms.2013.10.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 10/27/2013] [Accepted: 10/29/2013] [Indexed: 10/26/2022]
Abstract
Clear cell odontogenic carcinoma (CCOC) is an extremely rare neoplasm, with only 74 cases in the English-language literature. It displays a propensity for the mandible, most commonly presenting in the fifth to seventh decades. Histopathologically, CCOC is characterized by sheets and islands of vacuolated and clear cells. The aggressive nature of CCOC was noted in its first description in 1985, although it was not formally classified as malignant by the World Health Organization until 2005. This report describes a case of CCOC presenting atypically in a young patient and at an uncommon site. The authors review the details of this case, outlining management strategies referencing their experience and that described in the other limited cases in the literature.
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Affiliation(s)
- Amardip S Kalsi
- DF2 in Restorative Dentistry, The Royal London Dental Hospital, London, United Kingdom.
| | - Stephen P Williams
- Core Trainee, Department of Otolaryngology-Head and Neck Surgery, Aintree University Hospital, Liverpool, United Kingdom
| | - Ketan A Shah
- Consultant, Department of Cellular Pathology, John Radcliffe Hospital, Headington, Oxford, United Kingdom
| | - Adekunmi Fasanmade
- Consultant, Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Headington, Oxford, United Kingdom
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28
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Swain N, Dhariwal R, Ray JG. Clear cell odontogenic carcinoma of maxilla: A case report and mini review. J Oral Maxillofac Pathol 2013; 17:89-94. [PMID: 23798837 PMCID: PMC3687196 DOI: 10.4103/0973-029x.110681] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring predominantly in posterior mandible during 5th-7th decades with a female predilection. It is a potentially aggressive tumor, capable of frequent recurrences and loco-regional and distant metastases. Till date, only 73 cases have been reported in the literature. Current case is of a 55-year-old woman with tumor mass extending from canine to molar region on the left maxillary arch. Being locally aggressive tumor with the capacity to metastasize, it demands to be distinguished from other primary and metastatic clear cell tumors of the oral and maxillofacial region. A brief compilation of the reported cases is being attempted in the current article to better understand the behavior of the tumor.
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Affiliation(s)
- Niharika Swain
- Department of Oral Pathology, M.G.M. Dental College and Hospital, Navi Mumbai, Maharashtra, India
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29
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Woolgar JA, Triantafyllou A, Ferlito A, Devaney KO, Lewis JS, Rinaldo A, Slootweg PJ, Barnes L. Intraosseous carcinoma of the jaws: a clinicopathologic review. Part II: Odontogenic carcinomas. Head Neck 2012; 35:902-5. [PMID: 22290834 DOI: 10.1002/hed.22923] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2011] [Indexed: 11/06/2022] Open
Abstract
This is the second of a 3-part review of the clinicopathologic features of intraosseous carcinoma of the jaws (IOCJ). This part deals with odontogenic carcinomas, rare entities that are difficult to evaluate because of changes in classification/nomenclature, lack of standardized diagnostic criteria, and variable consistency of the existing literature. Endorsing a critical approach, problems are addressed and areas of uncertainty are highlighted. As in part I, we emphasize histopathologic features from a diagnostic point of view and also question the existence of some "distinct" entities.
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Affiliation(s)
- Julia A Woolgar
- Oral Pathology, School of Dental Sciences and Dental Hospital, University of Liverpool, Liverpool, United Kingdom
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30
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31
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Bilodeau EA, Hoschar AP, Barnes EL, Hunt JL, Seethala RR. Clear cell carcinoma and clear cell odontogenic carcinoma: a comparative clinicopathologic and immunohistochemical study. Head Neck Pathol 2011; 5:101-7. [PMID: 21290202 PMCID: PMC3098331 DOI: 10.1007/s12105-011-0244-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 01/20/2011] [Indexed: 01/24/2023]
Abstract
Clear cell carcinoma or hyalinizing clear cell carcinoma (CCC) and clear cell odontogenic carcinoma (CCOC) are rare, low-grade and typically indolent malignancies that can be diagnostically challenging. In this study the clinicopathologic, histologic, and immunohistochemical features of 17 CCCs and 12 CCOCs are examined. The differential diagnosis of clear cell malignancies in the head and neck is discussed. The relationship of CCCs and CCOCs to other clear cell tumors on the basis of their immunohistochemical staining patterns is postulated.
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Affiliation(s)
- Elizabeth A. Bilodeau
- Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, 3501 Terrace St, Pittsburgh, PA 15261 USA
| | - Aaron P. Hoschar
- Department of Pathology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44106 USA
| | - E. Leon Barnes
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - Jennifer L. Hunt
- Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA USA
| | - Raja R. Seethala
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
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32
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Zhang J, Liu L, Pan J, Tian X, Tan J, Zhou J, Duan Y. Clear cell odontogenic carcinoma: report of 6 cases and review of the literature. Med Oncol 2010; 28 Suppl 1:S626-33. [DOI: 10.1007/s12032-010-9668-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Accepted: 08/18/2010] [Indexed: 10/19/2022]
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33
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Clear-Cell Odontogenic Carcinoma: A New Case and Long-Term Follow-Up of an Old Case, and Review of the Literature. J Oral Maxillofac Surg 2009; 67:1342-8. [DOI: 10.1016/j.joms.2008.06.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Revised: 03/02/2008] [Accepted: 06/16/2008] [Indexed: 11/21/2022]
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34
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Chaine A, Pitak-Arnnop P, Dhanuthai K, Bertrand JC, Bertolus C. An asymptomatic radiolucent lesion of the maxilla. Clear cell odontogenic carcinoma. ACTA ACUST UNITED AC 2008; 107:452-7. [PMID: 19071036 DOI: 10.1016/j.tripleo.2008.09.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Revised: 09/06/2008] [Accepted: 09/09/2008] [Indexed: 11/19/2022]
Affiliation(s)
- André Chaine
- Department of Maxillofacial Surgery, AP-HP, Pitié-Salpêtrière University Hospital, Faculty of Medicine, University Paris 6 (Pierre et Marie Curie), Paris, France
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35
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Xavier FCA, Rodini CO, Ramalho LMP, Sarmento VA, Nunes FD, de Sousa SCOM. Clear cell odontogenic carcinoma: case report with immunohistochemical findings adding support to the challenging diagnosis. ACTA ACUST UNITED AC 2008; 106:403-10. [PMID: 18602308 DOI: 10.1016/j.tripleo.2008.03.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 02/08/2008] [Accepted: 03/10/2008] [Indexed: 11/19/2022]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis, and low survival. We report a case of CCOC affecting the mandible of a 39-year-old man. The tumor presented a biphasic pattern composed of clear cell nests intermingled with eosinophilic cells and separated by collagenous stroma. Immunoreactivity to cytokeratin (CK), specifically AE1/AE3 and CK 8, 14, 18, and 19 was found, as well as to epithelial membrane antigen (EMA). The tumor cells were negative for S100 protein, CK 13, vimentin, smooth muscle actin, laminin and type IV collagen. Low labeling indices for the proliferation markers Ki-67 and proliferating cell nuclear antigen and to p53 protein might predict a favorable prognosis for the lesion. A surgical resection was performed, followed by adjuvant radiotherapy. A 2-year follow-up has shown no signs of recurrence. The significance of histochemical and immunohistochemical resources in the correct diagnosis of CCOC is analyzed.
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Chera BS, Villaret DB, Orlando CA, Mendenhall WM. Clear cell odontogenic carcinoma of the maxilla: a case report and literature review. Am J Otolaryngol 2008; 29:284-90. [PMID: 18598842 DOI: 10.1016/j.amjoto.2007.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Accepted: 08/05/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clear cell odontogenic carcinoma (CCOC) is a rare tumor of odontogenic origin. It was first described as a clinicopathological entity in 1985, and since then, several case reports have been published. METHODS We present a patient with CCOC treated at the University of Florida and review the pertinent literature. RESULTS We treated a 52-year-old woman with CCOC of the maxilla. She received a maxillectomy and postoperative radiotherapy (RT). She developed pulmonary metastases 2 years after treatment. She remains alive and asymptomatic 7 years after completing treatment and has not required additional therapy. The literature search yielded 48 other case reports. The median age at presentation was 53 years (mean, 55 years), the female-to-male ratio was 2:1, and the most common site of presentation was the mandible. Three patients presented with submandibular lymphadenopathy. Most patients had a surgical resection (35 patients, 71%); the remainder underwent curettage. Six (12%) patients received postoperative RT. Eighty percent of patients who were initially treated with curettage developed a local recurrence. Local and/or regional recurrences occurred in 34% of patients who underwent surgical resection. Six patients developed distant metastatic disease; the most common site of the metastases was the lung. Seven patients died from or with the disease, and 3 are alive with the disease. CONCLUSIONS Clear cell odontogenic carcinoma is a rare tumor of the mandible and maxilla that has the propensity for local destruction and the potential for lymphatic and hematogenous metastases. We recommend radical excision as the primary treatment and that adjuvant RT be added for those who have close or positive margins as well as those with lymph node metastases.
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Affiliation(s)
- Bhishamjit S Chera
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
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Abstract
Malignant odontogenic tumors are extremely rare. As with benign odontogenic tumors, malignant epithelial odontogenic tumors or odontogenic carcinomas are distinguished from the even rarer mesenchymal ones, the odontogenic sarcomas. The existence of odontogenic carcinosarcomas is not yet acknowledged by the World Health Organization. Odontogenic carcinomas comprise ameloblastic carcinoma (AmCa), primary intraosseous carcinoma (PIOC), clear cell odontogenic carcinoma, odontogenic ghost cell carcinoma (OGCC), and the special case of metastasizing ameloblastoma. Odontogenic sarcomas consist of ameloblastic fibrosarcoma and ameloblastic fibrodentinosarcoma and fibroodontosarcoma. Whereas metastasizing ameloblastoma can be diagnosed only after having metastasized, all other malignant odontogenic tumors present with atypia, increased cellularity and mitoses, and invasion. Odontogenic sarcomas are regarded as low-grade tumors that rarely metastasize. Odontogenic carcinomas, however, especially AmCa, OGCC, and PIOC, are more aggressive, with a 5-year survival rate of about 70% for AmCa and OGCC and a 3-year survival rate of about 37% for PIOC. Radical surgery, eventually in combination with radiotherapy, is the treatment of choice.
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Affiliation(s)
- G Jundt
- Institut für Pathologie, DÖSAK-Zentralregister am Knochentumor-Referenzzentrum, Universitätsspital Basel, Schweiz.
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Avninder S, Rakheja D, Bhatnagar A. Clear cell odontogenic carcinoma: a diagnostic and therapeutic dilemma. World J Surg Oncol 2006; 4:91. [PMID: 17156493 PMCID: PMC1705808 DOI: 10.1186/1477-7819-4-91] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2006] [Accepted: 12/12/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring in the anterior region of the mandible in 5th-7th decades and shows a female preponderance. It is potentially aggressive, capable of frequent recurrences and loco-regional and distant metastases. CASE PRESENTATION A 45-year-old woman presented with a radiolucent left mandibular swelling associated with loss of teeth. Left cervical lymph nodes were enlarged on palpation. The patient underwent resection of the tumor but consequent to resected margins being positive for tumor cells underwent left hemimandibulectomy with ipsilateral functional neck dissection and was free of recurrence at 8 months follow-up. CONCLUSION Clear cell odontogenic carcinoma should be considered in the differential diagnosis of jaw tumors with conspicuous clear cell component. Curettage or conservative resection inevitably results in recurrences and/or metastasis and more radical resection is warranted in these tumors, especially when they are large and show soft tissue invasion.
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Affiliation(s)
- Singh Avninder
- Institute of Pathology-ICMR, Safdarjung Hospital Campus, New Delhi, India
| | - Dinesh Rakheja
- Department of Pathology, University of Texas Southwestern medical center, Dallas, Texas, USA
| | - Amar Bhatnagar
- Department of Cancer Surgery, Safdarjung Hospital, New Delhi, India
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