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Sharma G, Mittal A. Diagnostic Utility of EWSR1 in Clear Cell Odontogenic Carcinoma: A Systematic Review. Indian J Otolaryngol Head Neck Surg 2024; 76:2227-2236. [PMID: 38883514 PMCID: PMC11169160 DOI: 10.1007/s12070-024-04543-9] [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: 11/21/2023] [Accepted: 02/01/2024] [Indexed: 06/18/2024] Open
Abstract
In the 2022, World Health Organisation classification of odontogenic tumours, the clear cell odontogenic carcinoma is designated as a malignant odontogenic tumour with high recurrence and aggressive behaviour. Deceptive behaviour in the context of a wide range of differentials presents a significant diagnostic problem. It is the fifth most commom type of malignant odontogenic tumor. A systematic assessment of published cases, case series, and retrospective investigations of diagnostic significance of EWSR1 gene in clear cell odontogenic carcinoma is presented to determine trends in presentation, diagnostic characteristics, treatment, and patient outcome. To locate papers reporting clear cell odontogenic carcinoma and EWSR1, extensive database searches were carried out. Demographics, tumour location, immunohistochemical and molecular tests, treatment, follow-up, and recurrence were the variables. 34 cases were detected; 52.9% (n = 18) of the cases were females. The average age was 62.5 years, with a range of 43-82 years. The average size ranged from 3.4 to 8 cm. The mandibular body was the most common location, followed by the maxilla. Maximum immunohistochemistry positivity revealed by CK 19, CKAE1/3, EMA and p63. Most common gene fusion detected was EWSR1-ATF1 in 62.4% of cases contributing to its diagnostic attributes. Surgical treatment was used in 97% of cases. The average follow-up period was 30.3 months, and recurrence was reported in 52.4% of the cases. CCOC can metastasize, and the prognosis is fair. This is first systematic review, where we have attempted to consolidate the mutational expression of EWSR1 in Clear cell odontogenic carcinoma. It is difficult to identify from other clear cell tumours of the head and neck region. It is crucial to distinguish it from other clear cell lesions because of its aggressiveness.
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Affiliation(s)
- Gitika Sharma
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana 124001 India
| | - Aashish Mittal
- Department of Endodontics, Army Dental Centre Research and Referral, New Delhi, India
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2
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Dixit S, Kumar A, Srinivasan K. A Current Review of Machine Learning and Deep Learning Models in Oral Cancer Diagnosis: Recent Technologies, Open Challenges, and Future Research Directions. Diagnostics (Basel) 2023; 13:1353. [PMID: 37046571 PMCID: PMC10093759 DOI: 10.3390/diagnostics13071353] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/25/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Cancer is a problematic global health issue with an extremely high fatality rate throughout the world. The application of various machine learning techniques that have appeared in the field of cancer diagnosis in recent years has provided meaningful insights into efficient and precise treatment decision-making. Due to rapid advancements in sequencing technologies, the detection of cancer based on gene expression data has improved over the years. Different types of cancer affect different parts of the body in different ways. Cancer that affects the mouth, lip, and upper throat is known as oral cancer, which is the sixth most prevalent form of cancer worldwide. India, Bangladesh, China, the United States, and Pakistan are the top five countries with the highest rates of oral cavity disease and lip cancer. The major causes of oral cancer are excessive use of tobacco and cigarette smoking. Many people's lives can be saved if oral cancer (OC) can be detected early. Early identification and diagnosis could assist doctors in providing better patient care and effective treatment. OC screening may advance with the implementation of artificial intelligence (AI) techniques. AI can provide assistance to the oncology sector by accurately analyzing a large dataset from several imaging modalities. This review deals with the implementation of AI during the early stages of cancer for the proper detection and treatment of OC. Furthermore, performance evaluations of several DL and ML models have been carried out to show that the DL model can overcome the difficult challenges associated with early cancerous lesions in the mouth. For this review, we have followed the rules recommended for the extension of scoping reviews and meta-analyses (PRISMA-ScR). Examining the reference lists for the chosen articles helped us gather more details on the subject. Additionally, we discussed AI's drawbacks and its potential use in research on oral cancer. There are methods for reducing risk factors, such as reducing the use of tobacco and alcohol, as well as immunization against HPV infection to avoid oral cancer, or to lessen the burden of the disease. Additionally, officious methods for preventing oral diseases include training programs for doctors and patients as well as facilitating early diagnosis via screening high-risk populations for the disease.
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Affiliation(s)
- Shriniket Dixit
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore 632014, India
| | - Anant Kumar
- School of Bioscience and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Kathiravan Srinivasan
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore 632014, India
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3
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Sun Y, Liu H, Lv Y, Chen F, Hu Y, Yang K, Zheng X, Zhang J. Recurring Clear Cell Odontogenic Carcinoma Involving Vertebra and Pleura: A Case Report and Literature Review. Int J Surg Pathol 2023; 31:203-212. [PMID: 35578546 DOI: 10.1177/10668969221098082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Clear cell odontogenic carcinoma is a rare malignancy, which is vary in behavior from indolent tumor to cases with frequent recurrence and rare metastasis. In this manuscript, we report a case of clear cell odontogenic carcinoma of right lower mandible with cervical lymph node metastasis in a 50-year-old female. The tumor recurred and metastasized to vertebra and pleura after adjuvant radiation and chemotherapy, and the patient died of the disease 29 months after diagnosis. Pathologically, the tumor was composed of epithelial nests dominated by clear cells with ameloblastoma-like pattern and biphasic pattern. The tumor cells showed strong positive for AE1/AE3, KRT19, KRT5/6, P63, focal positive for KRT7, and weak positive for MUC1. Molecularly, EWSR1::ATF1 gene fusion was identified. To our knowledge, this report describes the first case of metastasis of clear cell odontogenic carcinoma involving regional lymph nodes and distant pleural and vertebral areas, demonstrating an aggressive clinical course of clear cell odontogenic carcinoma.
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Affiliation(s)
- Yanan Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079.,Oral Histopathology Department, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079
| | - Hanzhong Liu
- 47900Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Xiaogan Central Hospital, Xiaogan, China, 432000
| | - Yinan Lv
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079.,Oral Histopathology Department, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079
| | - Fu Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079.,Oral Histopathology Department, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079
| | - Yaying Hu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079.,Oral Histopathology Department, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079
| | - Ke Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079.,Oral Histopathology Department, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079
| | - Xiaofeng Zheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079.,Oral Histopathology Department, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079
| | - Jiali Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079.,Oral Histopathology Department, School and Hospital of Stomatology, 12390Wuhan University, Wuhan, China, 430079
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4
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Xie R, Wang W, Thomas AM, Li S, Qin H. Maxillary clear cell odontogenic carcinoma with EWSR1-ATF1 fusion gene mimicking sclerosing odontogenic carcinoma: A case report and literature review. Pathol Res Pract 2023; 241:154257. [PMID: 36470043 DOI: 10.1016/j.prp.2022.154257] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/11/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022]
Abstract
Both clear cell odontogenic carcinoma (CCOC) and sclerosing odontogenic carcinoma (SOC) are rare odontogenic malignancies. Here, we report a case of maxillary CCOC whose clinical and histologic features resembled those of SOC. Radiologically, the tumor presented as an ill-defined, expansile radiolucency with local bone destruction. Histologically, the tumor was comprised of thin cords or strands of odontogenic epithelium permeating through a sclerosed fibrous stroma with occasional clear cell foci. It damaged the cortical plates and invaded the adjacent soft tissue. Immunohistochemical expression of Pancytokeratin, Cytokeratin 19, p63, Cytokeratin 5/6, and Cytokeratin 14, as well as focal expression of Cytokeratin 7, demonstrated the epithelial nature of the tumor. Alcian Blue Periodic acid Schiff staining revealed a lack of intracellular mucin. Fluorescence in situ hybridization analysis revealed Ewing sarcoma RNA binding protein 1 and activating transcription factor 1 gene translocation, further confirming the diagnosis of CCOC. Lastly, we contextualized the genetic analysis of our case to that of CCOC in the literature.
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Affiliation(s)
- Ru Xie
- Department of Pathology, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Wenbo Wang
- Department of Pathology, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Aline M Thomas
- The Russell H. Morgan Department of Radiology and Radiological Sciences, the Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shen Li
- Department of Neurology and Psychiatry, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Huamin Qin
- Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
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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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Clear Cell Odontogenic Carcinoma: a Clinicopathological and Immunocytochemical Analysis. Pathol Oncol Res 2019; 26:1559-1564. [PMID: 31482399 DOI: 10.1007/s12253-019-00741-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/27/2019] [Indexed: 10/26/2022]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis and low survival. To date, only 67 cases have been described in the English language literature, and an understanding of the behavior of CCOC has been based on limited case reports. The aim of the research was to further reveal the features of CCOC. We report 5 new cases of CCOC, with a mean age of 52.4 years. The clinical and histopathologic data of the disease obtained from earlier literature (95 cases) and the 5 new cases were analyzed. Data were extracted, including demographics, histopathologic findings, clinical presentation, primary treatment and outcomes. Immunohistochemical results revealed that the cancer is positive for AE1/AE3, EMA and CK19, negative for smooth muscle actin SMA, Vim and S-100. EWSR1 translocation was also observed in the new cases, which may help in the diagnosis of CCOC. Metastases of CCOC were rare, but the local recurrence rate of CCOC rose to 42%. The best treatment for patients with CCOC is wide local excision combined with regional lymph node dissection.
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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: 3.8] [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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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: 1.9] [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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10
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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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11
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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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12
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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: 4.5] [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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13
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Torres-Rendon AC, Vered M, Speight PM. Clinical pathologic conference case 3: a challenging case of an enlarging swelling of the maxilla. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e67-71. [PMID: 23926614 DOI: 10.1016/j.oooo.2013.01.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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14
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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: 2.3] [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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15
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Hussain O, Rendon AT, Orr RL, Speight PM. Sclerosing odontogenic carcinoma in the maxilla: a rare primary intraosseous carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e283-6. [PMID: 23567261 DOI: 10.1016/j.oooo.2013.01.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 01/04/2013] [Accepted: 01/14/2013] [Indexed: 11/28/2022]
Abstract
Sclerosing Odontogenic Carcinoma (SOC) was first described by Koutlas et al. in 2008. SOC is a low-grade odontogenic carcinoma, which presents as an expansile radiolucency that causes tooth displacement and root resorption. It is locally aggressive but reports suggest a very low probability of regional or distant metastasis. SOC contains small nests and thin cords of small cuboidal or polygonal epithelial cells with cytoplasmic clearing. Pleomorphism and mitoses are not prominent. Skeletal muscle and perineural infiltration with stromal sclerosis is characteristic. Immunohistochemically, SOC stains for cytokeratins (CK) 5/6 and 19, and e-cadherin. Nuclear staining with p63 is also positive. CK20, carcinoembryonic antigen and CAM 5.2 are negative. We report a rare entity of primary intraosseous carcinoma of the maxilla which has the clinical and histological markers of SOC. Occurrence in the maxilla has been reported only once before in the literature.
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Affiliation(s)
- Omar Hussain
- Specialist Trainee Registrar, Sheffield Teaching Hospitals, Sheffield, United Kingdom
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16
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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: 1.4] [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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17
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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: 4.8] [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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18
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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: 1.2] [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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19
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