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Shah SJ, Tandon S, Ratnani C, Sonwani I, Bishal J. Calcifying Epithelial Odontogenic Cysts of the Anterior Maxilla: Report of Two Cases. Cureus 2024; 16:e65392. [PMID: 39071068 PMCID: PMC11272914 DOI: 10.7759/cureus.65392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2024] [Indexed: 07/30/2024] Open
Abstract
This article is a discussion of two cases of young adults with lesions in similar locations in the anterior maxilla, i.e., the canine-to-canine region, similar history, and comparable radiology. Both cases were histologically diagnosed as calcifying odontogenic cysts. Case 1 was a male aged 28 years with diffuse, firm left malar area facial swelling with pain in associated teeth for a month. Intraorally, he had a gingivo-vestibular swelling also extending palatally in the anterior left maxillary region extending from the distal surface of the left maxillary central incisor to the mesial surface of the left maxillary canine. The overlying mucosa was normal in appearance. The radiograph showed a large unilocular radiolucency in the affected region. The lesion was excised followed by curettage and primary closure. Case 2 was a female aged 25 years with a lumpy mass and pain in associated teeth since one year in the left canine-premolar region with an external swelling in the left ala of the nose region that extended superiorly to the zygomatic arch. The color of the skin as well as the intraoral mucosa was normal, and an orthopantomogram (OPG)revealed a unilocular radiolucency in the left maxillary canine-premolar region with resorption of premolar roots. Treatment included surgical enucleation and bone curettage. Both cases have been in follow-up for about a year and have shown non-incidental healing.
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Affiliation(s)
| | - Sarita Tandon
- Oral Pathology, Government Dental College, Raipur, IND
| | | | - Indu Sonwani
- Oral Pathology, Government Dental College, Raipur, IND
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2
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Al-Sammak A, Rezki O, Pennington M, Manosca F, Cuevas-Nunez M, Qaisi M, Greenbaum E, Murphy J. Treatment challenges of persistent ghost cell odontogenic carcinoma: a case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:e123-e132. [PMID: 37330392 DOI: 10.1016/j.oooo.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/10/2023] [Accepted: 04/17/2023] [Indexed: 06/19/2023]
Abstract
The aim of this case report is to review and compare the clinical, radiologic, histopathologic, and immunohistochemical features, along with the treatment of a case of ghost cell odontogenic carcinoma. In addition, a report of the existing published literature with an emphasis on treatment will be described to provide information on this rare but aggressive tumor. The family of odontogenic ghost cell tumors comprises a spectrum of lesions characterized by odontogenic epithelium with ghost cell keratinization and calcifications. It appears that early detection is vital in proper treatment due to the high possibility of malignant transformation.
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Affiliation(s)
- Ali Al-Sammak
- Department of Oral and Maxillofacial Surgery, John H Stroger Jr Hospital, Chicago, IL, USA
| | - Othman Rezki
- Department of Oral and Maxillofacial Surgery, John H Stroger Jr Hospital, Chicago, IL, USA
| | - Michael Pennington
- College of Dental Medicine, Midwestern University, Downers Grove, IL, USA
| | - Frances Manosca
- Department of Pathology, John H Stroger Jr Hospital, Chicago, IL, USA
| | - Maria Cuevas-Nunez
- College of Dental Medicine, Midwestern University, Downers Grove, IL, USA
| | - Mohammed Qaisi
- Department of Oral and Maxillofacial Surgery, John H Stroger Jr Hospital, Chicago, IL, USA
| | - Even Greenbaum
- Department of Otolaryngology, Northwestern Medicine, Chicago, IL, USA; Department of Otolaryngology, John H Stroger Jr Hospital, Chicago, IL, USA
| | - James Murphy
- Department of Oral and Maxillofacial Surgery, John H Stroger Jr Hospital, Chicago, IL, USA; Plastic and Reconstructive Surgery, Rush University Medical Center, Chicago, IL, USA.
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3
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Seki-Soda M, Sano T, Matsumura N, Takayama Y, Gomi A, Ogawa M, Yokoo S, Oyama T. Ghost cell odontogenic carcinoma arising in dentinogenic ghost cell tumor with next-generation sequencing cancer panel analysis: A case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:e58-e65. [DOI: 10.1016/j.oooo.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/23/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
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de Souza Vieira G, de Pinho Montovani P, Rozza-de-Menezes RE, Cunha KSG, Conde DC. Comparative Analysis Between Dentinogenic Ghost Cell Tumor and Ghost Cell Odontogenic Carcinoma: A Systematic Review. Head Neck Pathol 2021; 15:1265-1283. [PMID: 34128137 PMCID: PMC8633206 DOI: 10.1007/s12105-021-01347-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/09/2021] [Indexed: 11/24/2022]
Abstract
Dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC) form a spectrum of rare benign and malignant odontogenic neoplasms, respectively. The aim of this study was to perform a comparative systematic review of the clinicopathological, genetic, therapeutic, and prognostic features of DGCT and GCOC. The electronic search was performed until December 2020 on seven electronic databases. Case reports, series, and research studies with enough histopathological criteria for diagnosis and all genomic studies were included. Both DGCT and GCOC showed a male prevalence (p = 0.043), with mandibular and maxillary predilections, respectively (p = 0.008). Peripheral DGCT (DGCTp) affected most elderly people (p < 0.001), and central DGCT (DGCTc) and GCOC occurred mainly in younger individuals. Unilateral enlargement of maxilla or mandible was the most common clinical sign associated with a radiolucent or mixed image. Ameloblastomatous epithelium was often present in both neoplasms. Basaloid and large cells with vesicular nuclei were also frequently seen in GCOC. β-catenin expression and mutations (CTNNB1 gene) were found in DGCT and GCOC. Conservative surgery was mostly used for DGCTp, while radical resection was chosen for DGCTc and GCOC. High recurrence rates were found in DGCTc and GCOC. Metastasis occurred in 16.7% of GCOC cases and the 5-year survival rate was 72.6%. DGCT and GCOC share numerous clinicopathological features and demand a careful histopathological evaluation, considering the overlap features with other odontogenic tumors and the possibility of malignant transformation of DGCT. A strict regular post-operative follow-up is mandatory due to high recurrence rates and metastatic capacity in GCOC.
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Affiliation(s)
- Gustavo de Souza Vieira
- Graduate Program in Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil
| | | | - Rafaela Elvira Rozza-de-Menezes
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil
| | - Karin Soares Gonçalves Cunha
- Graduate Program in Pathology, School of Medicine, Federal Fluminense University, Niterói, RJ, Brazil
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil
| | - Danielle Castex Conde
- Department of Pathology, School of Medicine, Hospital Universitário Antônio Pedro, Federal Fluminense University, Av. Marquês do Paraná, 303, 4ºandar, sala 01, Centro, Niterói, RJ, 24033-900, Brazil.
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5
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Harada H, Sato MP, Otsuki N, Kawamura M, Kurose A, Satou T. A novel parotid carcinoma with a prominent ghost cell population: a masquerading tumor or "salivary ghost cell carcinoma"? Med Mol Morphol 2021; 55:76-83. [PMID: 34392428 DOI: 10.1007/s00795-021-00302-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022]
Abstract
Ghost cell is one of several unique cellular morphologies associated with aberrant keratinization. We encountered a novel parotid tumor containing numerous ghost cells and herein describe its histological features and discuss diagnostic problems. The patient was a 90-year-old Japanese male, who complained of swelling of the left parotid area for four months. Positron emission tomography indicated no cervical lymph node metastasis or distant metastasis. The tumor was successfully resected with no signs of recurrence or metastasis for six months after surgery. Histologically, the tumor was mainly composed of squamous cells forming irregularly shaped nests with a mixture of pleomorphic giant or multinucleated cells and bland basaloid cell. Keratinized areas were occupied by a prominent ghost cell population. Immunohistochemically, CK5/6 and CK19 were widely positive as well as AE1/AE3, p40 and p63. Nuclear expression of β-catenin was also observed. The present case can be regarded as a particular form of squamous cell carcinoma and is believed to contain a large number of ghost cells resulting from an unclear mechanism. However, it seems difficult to consider such tumors as a clinicopathologically independent entity at present. Applying a term such as "salivary ghost cell carcinoma" would be premature.
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Affiliation(s)
- Hiroshi Harada
- Department of Diagnostic Pathology, Kindai University Hospital, 377-2 Ohnohigashi, Osaka-Sayama, 589-8511, Japan. .,Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Mitsuo P Sato
- Department of Otorhinolaryngology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Naoki Otsuki
- Department of Otorhinolaryngology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Mao Kawamura
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Akira Kurose
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takao Satou
- Department of Diagnostic Pathology, Kindai University Hospital, 377-2 Ohnohigashi, Osaka-Sayama, 589-8511, Japan
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Vijayakumar G, Kamboj M, Narwal A, Devi A. Ghost cell odontogenic carcinoma of anterior mandible: A rare case report with review of literature. J Oral Maxillofac Pathol 2021; 25:S99-S108. [PMID: 34083982 PMCID: PMC8123258 DOI: 10.4103/jomfp.jomfp_195_20] [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: 05/09/2020] [Accepted: 01/29/2021] [Indexed: 12/18/2022] Open
Abstract
A 24-year-old male reported to the outpatient department with a complaint of swelling of the anterior lower jaw region for 9 months with history of traumatic injury and extraction of teeth from the same region, a month before the onset of swelling. Swelling was obvious extra- and intraorally which on examination presented as a soft to firm non-tender and non-fluctuant mass with an approximate size of 4 cm × 3 cm, extending from 34 to 43 region with obliteration of labial vestibule. Panoramic radiograph and cone-beam computed tomography showed a well-defined radiolucency in the mandibular anterior region crossing the midline with erosion of labial bony plates and root of 42 along with a tooth-like radiopaque mass within the lesion. Provisional diagnoses of odontogenic keratocyst, ameloblastomas, central giant cell granuloma and calcifying epithelial odontogenic tumor were listed. The histopathological and immunohistochemical examination of lesion followed by the biopsy confirmed the diagnosis of Ghost cell odontogenic carcinoma.
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Affiliation(s)
- Gopikrishnan Vijayakumar
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Post Graduate Institute of Dental Sciences, Pt. BD Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Mala Kamboj
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Post Graduate Institute of Dental Sciences, Pt. BD Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Anjali Narwal
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Post Graduate Institute of Dental Sciences, Pt. BD Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Anju Devi
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Post Graduate Institute of Dental Sciences, Pt. BD Sharma University of Health Sciences, Rohtak, Haryana, India
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7
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Jia MQ, Jia J, Wang L, Zou HX. Ghost cell odontogenic carcinoma of the jaws: Report of two cases and a literature review. World J Clin Cases 2019; 7:357-365. [PMID: 30746377 PMCID: PMC6369398 DOI: 10.12998/wjcc.v7.i3.357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/27/2018] [Accepted: 12/21/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ghost cell odontogenic carcinoma (GCOC) is a rare malignant odontogenic epithelial tumor with features of benign calcifying odontogenic cysts. Herein, we report two new cases of GCOC and systematically review the previous literature.
CASE SUMMARY In case 1, a 46-year-old man complained of painless swelling of the right maxilla for 3 years, with a 1-mo history of hemorrhinia in the right nasal cavity. In case 2, a 72-year-old man was referred to our hospital with a chief complaint of painful swelling of the right mandible. Initially, the preliminary diagnoses were ameloblastomas. Thus, the two patients underwent resection of the tumor under general anesthesia. Finally, immunohistochemical examination confirmed the diagnosis of GCOC. The patient in case 1 was followed for 2 years, with no evidence of recurrence. However, the patient in case 2 was lost to follow-up.
CONCLUSION GCOC is a rare malignant odontogenic epithelial tumor with high recurrence. Local extensive resection is necessary for the definitive treatment of GCOC.
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Affiliation(s)
- Meng-Qi Jia
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Jun Jia
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Li Wang
- Department of Pathology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Hai-Xiao Zou
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
- Department of Stomatology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
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8
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Ohata Y, Kayamori K, Yukimori A, Sumikura K, Ohsako T, Harada H, Sakamoto K, Ikeda T. A lesion categorized between ghost cell odontogenic carcinoma and dentinogenic ghost cell tumor with CTNNB1 mutation. Pathol Int 2018; 68:307-312. [PMID: 29575443 DOI: 10.1111/pin.12659] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/16/2018] [Indexed: 02/06/2023]
Abstract
Ghost cell odontogenic carcinoma (GCOC) is a rare malignant neoplasm characterized by the presence of ghost cells. It is considered to arise either de novo or from a preexisting benign precursor, calcifying odontogenic cyst (COC), or dentinogenic ghost cell tumor (DGCT). We report a case of a 44-year-old Japanese male with a left maxillary tumor. The patient received treatment to resect the left maxillary cyst 25 years prior; however, the details were uncertain. The tumor was resected with clear margins. Taken together with the results of histological and immunohistochemical examinations, the tumor was categorized between GCOC and DGCT, and we diagnosed the tumor as GCOC suggesting similarity to DGCT. Further, we focused on CTNNB1, which encodes β-catenin and is frequently mutated in COCs. In this tumor, we identified CTNNB1 Ser33Cys, one of the mutations typically found in COCs. This finding suggests that CTNNB1 is a common target for the pathogenesis of tumors accompanied by ghost cells.
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Affiliation(s)
- Yae Ohata
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kou Kayamori
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akane Yukimori
- Department of Diagnostic Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kanako Sumikura
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshimitsu Ohsako
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kei Sakamoto
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tohru Ikeda
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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9
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Qin Y, Lu Y, Zheng L, Liu H. Ghost cell odontogenic carcinoma with suspected cholesterol granuloma of the maxillary sinus in a patient treated with combined modality therapy: A case report and the review of literature. Medicine (Baltimore) 2018; 97:e9816. [PMID: 29443742 PMCID: PMC5839843 DOI: 10.1097/md.0000000000009816] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Ghost cell odontogenic carcinoma (GCOC) is a rare malignant odontogenic tumor with aggressive growth characteristics. PATIENT CONCERNS A 41-year-old Chinese male visited our hospital in 2013, with a 4-month history of bloody purulent rhinorrhea with a peculiar smell in the right nasal cavity. DIAGNOSES The patient suffered from recurrent GCOC with suspected cholesterol granuloma of the maxillary sinus. The patient was incorrectly diagnosed with a calcifying epithelial odontogenic tumor at his first recurrence. Physical examination, radiological examination, and histopathology were used to identify GCOC. INTERVENTIONS Considering the recurrence of GCOC and poor effects of single surgery, postoperative adjuvant chemotherapy and concurrent chemoradiotherapy were performed after radical surgical excision. OUTCOMES So far, no significant evidence has suggested recurrence or metastasis after a long-term follow-up. LESSONS We advocate wide surgery with clean margins at the first accurate diagnosis. Combined modality therapy could be taken for the recurrent GCOC. We expect to provide a new treatment strategy to prevent the growth of this neoplasm.
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Affiliation(s)
| | | | | | - Hong Liu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Park SY, Park J, Kwon DH, Jeon JH, Kim SM, Myoung H, Lee JH. Ghost cell odontogenic carcinoma on right mandible and its respective surgical reconstruction: a case report. J Korean Assoc Oral Maxillofac Surg 2017; 43:415-422. [PMID: 29333372 PMCID: PMC5756799 DOI: 10.5125/jkaoms.2017.43.6.415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 06/27/2017] [Accepted: 07/05/2017] [Indexed: 11/07/2022] Open
Abstract
Calcifying cystic odontogenic tumor (CCOT) is defined as an odontogenic cyst-like benign neoplasm that characteristically contains several ghost cells, ameloblastoma-like epithelium, and occasional calcification. Ghost cell odontogenic carcinoma (GCOC), a malignant form of CCOT, is an exceptionally rare malignant tumor. In this report, we present a case of a 53-year-old man whose chief complaint was a solitary mass on the right mandible area. The mass was completely removed through an extraoral surgical approach and reconstructive surgery was performed in two phases.
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Affiliation(s)
- Sang Yoon Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Joonhyoung Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Do Hyun Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jae Ho Jeon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jong Ho Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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11
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Sharma B, Koshy G, Kapoor S. Calcifying odontogenic cyst with luminal and mural component (Type 1c). Indian J Dent 2016; 7:95-8. [PMID: 27433053 PMCID: PMC4934095 DOI: 10.4103/0975-962x.184648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Calcifying odontogenic cyst (COC) was first described and classified by Gorlin et al. It is defined as a cystic lesion in which the epithelial lining shows a well defined basal layer of columnar cells, an overlying layer that often resemble stellate reticulum and masses of ghost cells that may be in the epithelial cystic lining or in the fibrous capsule. The lesion generally occurs in the region anterior to maxillary and mandibular molars and either intraosseous or extraosseus. This entity might present as a cystic or solid lesion. Praetorius et al. classified COC into 2 main entities namely a cyst (Type 1) and a neoplasm (Type 2). The present case report exhibit a cystic lesion with both luminal and mural component.
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Affiliation(s)
- Bhushan Sharma
- Department of Oral Pathology and Microbiology, Christian Dental College, CMC, Ludhiana, Punjab, India
| | - George Koshy
- Department of Oral Pathology and Microbiology, Christian Dental College, CMC, Ludhiana, Punjab, India
| | - Shekhar Kapoor
- Department of Oral Medicine and Radiology, Christian Dental College, CMC, Ludhiana, Punjab, India
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12
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Schuster D, Cure J, Woodworth BA. Transnasal endoscopic resection of a calcifying cystic odontogenic tumor. EAR, NOSE & THROAT JOURNAL 2016; 93:E28-30. [PMID: 25181672 DOI: 10.1177/014556131409300824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Calcifying cystic odontogenic tumor (CCOT) is a rare histologic subtype of odontogenic tumor. Treatment requires complete enucleation. We report what we believe is the first case of CCOT to be removed via a transnasal endoscopic approach. A 16-year-old boy was referred to our department by his dentist for evaluation of an expansile mass of the left maxillary sinus. The dentist had noted an area of hyperlucency of the left palate during a routine examination. Computed tomography confirmed the presence of a large tumor. Complete resection of the tumor was achieved via a transnasal endoscopic surgical approach. Resection of odontogenic tumors is necessary because of their tendency to expand and produce a mass effect on surrounding structures. We believe resection via an entirely transnasal endoscopic approach is a valuable and important technique in the treatment of odontogenic tumors that leaves the patient with a more cosmetically acceptable postoperative appearance.
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Affiliation(s)
- Daniel Schuster
- Division of Otolaryngology, Department of Surgery, University of Alabama at Birmingham, BDB 563, 1530 3rd Ave., S, Birmingham, AL 35294, USA
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13
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Rappaport MJ, Showell DL, Edenfield WJ. Metastatic Ghost Cell Odontogenic Carcinoma: Description of a Case and Search for Actionable Targets. Rare Tumors 2015; 7:5813. [PMID: 26500725 PMCID: PMC4600987 DOI: 10.4081/rt.2015.5813] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/27/2015] [Accepted: 04/24/2015] [Indexed: 12/19/2022] Open
Abstract
Ghost cell odontogenic carcinoma (GCOC) is an exceedingly rare malignant tumor on the spectrum of already uncommon odontogenic or dentinogenic tumors. We describe here the case of metastatic GCOC in a patient with a history of recurrent dentinogenic ghost cell tumor of the mandible, now presenting with bilateral pleural effusions. We will discuss typical histopathologic and histochemical features of GCOC, along with results of genomic testing and their role in directing therapy.
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Affiliation(s)
| | - Darion L Showell
- Greenville Health System, University of South Carolina School of Medicine , SC, USA
| | - William J Edenfield
- Greenville Health System, University of South Carolina School of Medicine , SC, USA ; Greenville Health System Cancer Institute , Greenville, SC, USA
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14
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Bose P, Pleasance ED, Jones M, Shen Y, Ch’ng C, Reisle C, Schein JE, Mungall AJ, Moore R, Ma Y, Sheffield BS, Thomson T, Rasmussen S, Ng T, Yip S, Lee CW, Ho C, Laskin J, Marra MA, Jones SJ. Integrative genomic analysis of ghost cell odontogenic carcinoma. Oral Oncol 2015; 51:e71-5. [DOI: 10.1016/j.oraloncology.2015.06.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 12/14/2022]
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15
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Malignant transformation of calcifying cystic odontogenic tumour - a review of literature. Contemp Oncol (Pozn) 2015; 19:184-6. [PMID: 26557757 PMCID: PMC4631291 DOI: 10.5114/wo.2015.52654] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 06/05/2014] [Accepted: 08/06/2014] [Indexed: 11/17/2022] Open
Abstract
Calcifying cystic odontogenic tumour (CCOT) has been classified as an odontogenic tumour. Ghost cell odontogenic carcinoma (GCOC) is the malignant counterpart of CCOT. This paper aims to review the literature regarding malignant transformation of CCOT. A literature search was done via the National Library of Medicine PubMed interface, searching for articles relating to malignant transformation of CCOT. From these articles, references were obtained, and from their references lists, pertinent secondary references were also identified and acquired. After reviewing the literature, we found 26 cases of GCOC which developed from CCOT. Malignant transformation of CCOT was seen more commonly in the maxilla. Histologically, changes such as increased nuclear/cytoplasmic ratio, atypical mitotic figures have been reported after malignant transformation. Immunohistochemical analysis has shown an increased expression of ki-67 and p53 in tumour cells. Malignant transformation of CCOT, although rare, mostly takes place in recurrent and long standing cases.
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Rajesh E, Jimson S, Masthan KMK, Balachander N. Ghost cell lesions. J Pharm Bioallied Sci 2015; 7:S142-4. [PMID: 26015694 PMCID: PMC4439654 DOI: 10.4103/0975-7406.155864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 10/31/2014] [Accepted: 11/09/2014] [Indexed: 11/04/2022] Open
Abstract
Ghost cells have been a controversy for a long time. Ghost cell is a swollen/enlarged epithelial cell with eosnophilic cytoplasm, but without a nucleus. In routine H and E staining these cells give a shadowy appearance. Hence these cells are also called as shadow cells or translucent cells. The appearance of these cells varies from lesion to lesion involving odontogenic and nonodontogenic lesions. This article review about the origin, nature and significance of ghost cells in different neoplasms.
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Affiliation(s)
- E Rajesh
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - Sudha Jimson
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - K M K Masthan
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - N Balachander
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
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Martos-Fernández M, Alberola-Ferranti M, Hueto-Madrid JA, Bescós-Atín C. Ghost cell odontogenic carcinoma: A rare case report and review of literature. J Clin Exp Dent 2014; 6:e602-6. [PMID: 25674335 PMCID: PMC4312695 DOI: 10.4317/jced.51809] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/12/2014] [Indexed: 12/20/2022] Open
Abstract
Objectives: Ghost cell odontogenic carcinoma is a rare condition characterized by ameloblastic-like islands of epithelial cells with aberrant keratinitation in the form of Ghost cell with varying amounts of dysplastic dentina.
Material and Methods: We report a case of a 70 year-old woman with a rapid onset of painful swelling right maxillary tumor. Magnetic resonance showed a huge tumor dependent on the right half of the right hard palate with invasion of the pterygoid process and focally to the second branch of the trigeminal. Radiological stage was T4N0. The patient underwent a right subtotal maxillectomy with clear margins. Adjuvant radiotherapy was given. The patient was free of residual or recurrent disease 12 months after surgery.
Results: The tumor was 3,9cm in diameter. It was spongy and whitish gray. Microscopically the tumor was arranged in nets and trabeculae, occasionally forming palisade. Tumoral cells had clear cytoplasm with vesicular nuclei. There was atipia and mitosi with vascular and perineural invasion. The excised tumor was diagnosed as a GCOC.
Conclusions: Ghost cell carcinoma is a rare odontogenic carcinoma. Its course is unpredictable, ranging from locally invasive tumors of slow growth to highly aggressive and infiltrative ones. Wide surgical excision with clean margins is the treatment of choice although its combination with postoperative radiation therapy, with or without chemotherapy, remains controversial.
Key words:Ameloblastic carcinoma, calcifying odontogenic cyst, Ghost cell carcinoma, keratinizing epithelial odontogenic cyst, maxillary tumor, odontogenic carcinoma.
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Affiliation(s)
- Míriam Martos-Fernández
- MD. Resident, Oral and Maxillofacial Surgery Department, Vall d'Hebrón Hospital. Barcelona, Spain
| | | | - Juan Antonio Hueto-Madrid
- MD, DDS. Assistant Surgeon, Oral and Maxillofacial Surgery Department, Vall d'Hebrón Hospital, Barcelona, Spain. Researcher of the VHIR group
| | - Coro Bescós-Atín
- PhD MD, DDS. Head of Oral and Maxillofacial Surgery Department, Vall d'Hebrón Hospital. Barcelona, Spain. Researcher of the VHIR group
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Ki-67 and p53 expression in ghost cell odontogenic carcinoma: a case report and literature review. Oral Maxillofac Surg 2014; 19:85-9. [PMID: 25216652 DOI: 10.1007/s10006-014-0465-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 09/02/2014] [Indexed: 02/05/2023]
Abstract
Ghost cell odontogenic carcinomas are rare neoplasms that arise in the maxillary bones either from a calcifying odontogenic cyst or de novo. They are aggressive locally and can metastasize. We report herein a case of a ghost cell odontogenic carcinoma arising in the mandible of a Caucasian male 86 years of age. We have described the clinical and radiographic features, histological characteristics, immunohistochemistry findings, and surgical treatment. We especially focused on how Ki-67 expression guides the treatment choice. Finally, we reviewed 32 cases described in the literature and compared them with the cases described up until 2014 to help clinicians identify the diagnostic characteristics of and select appropriate treatment modalities for ghost cell odontogenic carcinomas.
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Predictive factors of potential malignant transformation in recurrent calcifying cystic odontogenic tumor: review of the literature. Case Rep Pathol 2013; 2013:853095. [PMID: 23956907 PMCID: PMC3728541 DOI: 10.1155/2013/853095] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 07/01/2013] [Indexed: 11/21/2022] Open
Abstract
Calcifying cystic odontogenic tumor (CCOT) demonstrates considerable diversity in histopathology and clinical behavior. Ghost cell odontogenic carcinoma (GCOC) is the rare malignant counterpart of CCOT and it frequently arises from malignant transformation of a recurrent CCOT. In this paper, we present a case of CCOT and discuss its distinct histopathologic features in recurrence. Then, we will have a review on clinical, histopathological, and immunohistochemical aspects of GCOC in the literature. Predictive factors of malignant transformation in a benign CCOT will also be discussed.
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Chindasombatjaroen J, Poomsawat S, Kakimoto N, Shimamoto H. Calcifying cystic odontogenic tumor and adenomatoid odontogenic tumor: radiographic evaluation. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 114:796-803. [PMID: 23159119 DOI: 10.1016/j.oooo.2012.08.452] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 08/22/2012] [Accepted: 08/27/2012] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of this study was to describe the radiographic features of calcifying cystic odontogenic tumors (CCOTs) and adenomatoid odontogenic tumors (AOTs) and to compare the radiographic findings for these 2 lesions. STUDY DESIGN We retrospectively reviewed radiographs of CCOTs and AOTs. Location, border, relationship of the lesion with the impacted tooth, calcification patterns, tooth displacement, and root resorption were evaluated. RESULTS Nine CCOTs and 8 AOTs were reviewed. Most CCOTs and AOTs had smooth borders. Three CCOTs and 7 AOTs enclosed impacted teeth. Of these cases, the radiolucencies of 3 CCOTs and 1 AOT were attached to the impacted teeth at the cementoenamel junctions. Three AOTs enclosed more portions of the roots, and the other 3 AOTs enclosed the entire teeth. Calcification in CCOTs appeared as a thin radiopaque line (2 cases) and discrete radiopaque foci (1 case), whereas AOTs had numerous dispersed or clustered radiopaque foci (4 cases). CONCLUSIONS Radiolucency with numerous radiopaque foci (particularly when the radiolucency surrounds a portion of the root or entire tooth) is suggestive of an AOT rather than a CCOT.
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Affiliation(s)
- Jira Chindasombatjaroen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
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Zhu ZY, Chu ZG, Chen Y, Zhang WP, Lv D, Geng N, Yang MZ. Ghost cell odontogenic carcinoma arising from calcifying cystic odontogenic tumor: a case report. KOREAN JOURNAL OF PATHOLOGY 2012; 46:478-82. [PMID: 23136575 PMCID: PMC3490111 DOI: 10.4132/koreanjpathol.2012.46.5.478] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 11/24/2011] [Accepted: 11/30/2011] [Indexed: 02/05/2023]
Abstract
Ghost cell odontogenic carcinoma (GCOC) is an exceptionally rare and malignant odontogenic tumor with aggressive growth characteristics. We describe a case of GCOC which was considerably derived from a previously resected calcifying cystic odontogenic tumor (CCOT). Cellular atypia, mitotic activity, Ki-67 labeling index and matrix metalloprotease-9 positive expression rate were all increased in the currently resected specimen compared to the initial one. This is a rare case of malignant transformation of CCOT to GCOC with respect to its histopathological and immunohistochemical findings.
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Affiliation(s)
- Zhi-Yu Zhu
- Department of Pathology, West China Hospital of Stomatology, Sichuan University, Sichuan, China
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Kikuchi K, Ito S, Inoue H, Gonz^|^aacute;lez-Alva P, Miyazaki Y, Sakashita H, Yoshino A, Katayama Y, Terui T, Ide F, Kusama K. Immunohistochemical expression of podoplanin in so-called hard ^|^alpha;-keratin-expressing tumors, including calcifying cystic odontogenic tumor, craniopharyngioma, and pilomatrixoma. J Oral Sci 2012; 54:165-75. [DOI: 10.2334/josnusd.54.165] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Saghafi S, Zare-Mahmoodabadi R, Salehinejad J, Kadeh H, Afzal-Aghaee M. Immunohistochemical analysis of p53 and PCNA expression in calcifying odontogenic cyst. J Oral Sci 2011; 52:609-13. [PMID: 21206164 DOI: 10.2334/josnusd.52.609] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Calcifying odontogenic cyst (COC) is a developmental odontogenic cyst in the jaw. Because of its diverse histopathologic features and biological behavior, there has long been confusion with regard to its nature as a cyst or neoplasm. This study evaluated the proliferative activity of 57 COC samples, including simple cyst (10 cases), cystic neoplasm (34 cases), solid neoplasm (6 cases) and combined lesion (7 cases) by p53 and PCNA immunohistochemical staining. For assessment of p53 and PCNA positivity, the number of positively stained cells with brown-stained nuclei was counted in 1000 cells from each sample. p53 and PCNA expression in the solid neoplasm subtype were significantly higher when compared to cystic neoplasm and simple cyst (P < 0.05). The lowest p53 and PCNA expression was found in the simple cyst subtype. p53 and PCNA expression in the basal and suprabasal layers was significantly higher in the solid subtype when compared to others, and the difference between COC groups was significant. The results demonstrated that within benign types of COC, the amount of p53 and PCNA in proliferative epithelium is significantly higher when compared to non-proliferative epithelium. p53 and PCNA markers are possible parameters for differentiation of COC subtypes.
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Affiliation(s)
- Shadi Saghafi
- Department of Oral and Maxillofacial Pathology, Dental Research Center, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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