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da Silveira KG, de Almeida Souto Montenegro L, de Albuquerque DS, do Lago CAP, Laureano Filho JR, de Vasconcellos RJH. Clinicopathological characteristics of odontogenic carcinosarcoma: A systematic review. J Oral Pathol Med 2024; 53:20-30. [PMID: 38164057 DOI: 10.1111/jop.13502] [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: 06/16/2023] [Revised: 10/04/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The aim of the present systematic review was to summarize evidence on odontogenic carcinosarcoma, analyzing clinical, epidemiological, imaging, histopathological, immunohistochemical, therapeutic, and prognostic features of this tumor. MATERIALS AND METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the Ovid MEDLINE (Wolters Kluwer), PubMed (National Library of Medicine), Web of Science (Thomson Reuters), Scopus (Elsevier), and LILACS (Latin American and Caribbean Center on Health Sciences Information) databases, without publication date or language restrictions. Case reports or case series of OCS reporting clinical, radiological, and histopathological data that confirmed the diagnosis were selected. The Joanna Briggs Institute-University of Adelaide tool was used for critical appraisal of the included articles. RESULTS Odontogenic carcinosarcoma is a rare, aggressive tumor associated with high mortality; however, the metastasis rate is low. The tumor has a male predilection. The mean patient age is 40 years, but there is no predilection for age. The left posterior mandible is the most affected site, but no specific radiographic features have been reported. CONCLUSION Given its rarity, dentists, oral-maxillofacial surgeons, and physicians need to be aware of odontogenic carcinosarcoma in order to increase the diagnostic potential, preventing delays in diagnosis and treatment and thus contributing to lower morbidity of the tumor.
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Nordio L, Costa A, Campigli M, Rondena M. Ameloblastic fibro-odontosarcoma with mandibular bone invasion and regional lymph node metastasis in a cat: case report. J Comp Pathol 2023; 207:18-20. [PMID: 37913747 DOI: 10.1016/j.jcpa.2023.09.008] [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: 07/03/2023] [Revised: 08/11/2023] [Accepted: 09/29/2023] [Indexed: 11/03/2023]
Abstract
Odontogenic tumours are uncommon neoplasms in domestic animals, mostly solitary and locally infiltrative, but rarely metastatic. We report the case of a 13-year-old neutered male cat presented with a mandibular gingival neoformation. A computed tomography scan revealed an irregular neoformation with marked post-contrast enhancement, associated with lysis of the incisive bone and mandibular symphysis. Histologically, the oral mucosa and mandibular bone were infiltrated by a neoplasm consisting of a mixed population of odontogenic epithelium admixed with bundles of odontogenic ectomesenchyme, multifocally associated with hard tissue deposition. A spindloid cell component had metastasized to the right mandibular lymph node. The epithelial component was immunoreactive for cytokeratins (CK) 5/6, CK 14, pancytokeratin (CK AE1/AE3) and p63; the ectomesenchymal component was vimentin positive. A final diagnosis of ameloblastic fibro-odontosarcoma with bone invasion and lymph node metastasis was made. The findings indicate the metastatic potential of this rare tumour.
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Affiliation(s)
- Laura Nordio
- Pathology Division, San Marco Veterinary Clinic and Laboratory, Via dell'Industria 3, 35030 Veggiano, Padua, Italy.
| | - Arianna Costa
- Diagnostic and Interventional Radiology Division, San Marco Veterinary Clinic and Laboratory, Via dell'Industria 3, 35030 Veggiano, Padua, Italy
| | - Michela Campigli
- Oncology Division, San Marco Veterinary Clinic and Laboratory, Via dell'Industria 3, 35030 Veggiano, Padua, Italy
| | - Marco Rondena
- Pathology Division, San Marco Veterinary Clinic and Laboratory, Via dell'Industria 3, 35030 Veggiano, Padua, Italy
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Born LJ, Khachemoune A. Basal cell carcinosarcoma: a systematic review and reappraisal of its challenges and the role of Mohs surgery. Arch Dermatol Res 2023; 315:2195-2205. [PMID: 36790451 DOI: 10.1007/s00403-023-02551-3] [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: 12/23/2022] [Revised: 12/23/2022] [Accepted: 01/22/2023] [Indexed: 02/16/2023]
Abstract
Basal cell carcinosarcoma (BCCS) is a rare malignant biphasic tumor of the skin, composed of epithelial and mesenchymal components, and may be underdiagnosed. We sought to summarize the current understanding of BCCS including its reported history, clinical presentation, diagnosis, and treatment. We also reappraise and present our recommendations of histological interpretation for its diagnosis and treatment. A systematic review of PubMed and EMBASE, from inception of databases to December 1, 2022, identified all reported cases of basal cell carcinosarcoma. A total of 34 reports containing 54 patients with basal cell carcinosarcoma were included. The neoplasm was most commonly associated in areas of sun-exposed skin and primarily affected the elderly. Diagnosis was made on histology specimens using H&E. To address underdiagnosis, additional immunohistochemical markers have been proposed due to unreliable phenotypic appearance in this poorly differentiated neoplasm. Treatment consists of excision of the tumor, typically with Mohs surgery, and is curative in most cases. There are limited treatment options for metastatic disease. There were limitations to this study as various immunohistochemical stains used on suspected BCCS without providing an explanation as to why certain markers were included and others were excluded. Continued efforts in characterizing this complex neoplasm are critical in establishing reliable and accurate diagnostic tests and accompanying treatment options, especially in cases of metastatic disease.
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Affiliation(s)
- Louis J Born
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Amor Khachemoune
- Department of Dermatology, Veterans Affairs Medical Center, and State University of New York, New York, NY, USA.
- Veterans Affairs Hospital and SUNY Downstate Dermatology Service, 800 Poly Place, Brooklyn, NY, 11209, USA.
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Cole G, Chi A, Cook DR, Kubik M, Bilodeau EA, Seethala RR. Odontogenic Carcinosarcoma: Clinicopathologic and Molecular Features of Three Cases, a Literature Review and Nomenclature Proposal. Head Neck Pathol 2023; 17:751-767. [PMID: 37486533 PMCID: PMC10513988 DOI: 10.1007/s12105-023-01569-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Odontogenic carcinosarcoma (OCS) is a rare odontogenic malignancy with limited characterization and unexplored molecular features. We report clinicopathologic and molecular findings in 3 additional OCS and review the literature. METHODS 3 OCS (5.1%) were identified among 59 malignant odontogenic tumors (in our archives from 1992 to 2022). Clinical, radiologic, histopathologic, immunophenotypic, and molecular findings were reviewed. Data from prior case reports and systematic or non-systematic reviews were extracted for analysis. RESULTS Three mandibular OCS (age range: 66 to 72 years; 1 male, 2 females) were identified. Case 1 had novel clear-cell morphology, multiple recurrences, and a lethal outcome 28 months after resection. EWSR1 rearrangements were negative, but the tumor showed focal nuclear β-catenin and strong LEF-1 immunoreactivity. Case 2 demonstrated ameloblastic and sclerosing features and encased the inferior alveolar nerve; the patient was disease-free 22 months after resection with adjuvant chemoradiation therapy. LEF-1 was again strongly positive, and next-generation sequencing demonstrated 9p region-(CDKN2A, CDKN2B) copy number loss, and 12q region-(MDM2, CDK4) copy number gain. Case 3 showed clear-cell and markedly sclerosing features; no follow-up information was available. Literature review along with the current cases yielded 20 cases. OCS showed a male predilection (1.5:1), mandibular predominance (80%, typically posterior), and a bimodal age distribution (modes: 27.7 years, 62.7 years). OCS presented as masses (100%), often with pain (55%), and paresthesia (45%). Tumors were typically radiolucent (88.9%), with bone destruction (61.1%), and/or tooth effacement (27.8%). Preoperative biopsy was sensitive for malignancy (85.7%). At least 45% show evidence for a precursor lesion. 3-year DSS and DFS were 58% and 35%, respectively. Regional and distant (usually lung) metastatic rates were 25% and 31.3%, respectively. Increased mitotic rates and presence of tumor necrosis trended toward worse DSS and DFS. CONCLUSION OCS is a rare but aggressive malignancy, often arising from precursor tumors and may represent a terminal phenotype rather than a distinct entity. We describe novel clear-cell and sclerosing morphologies. Wnt pathway alterations appear important. Mitotic rates and necrosis may be adverse prognosticators. In keeping with nomenclature trends in other sites, OCS may be more appropriately designated as "biphasic sarcomatoid odontogenic carcinomas."
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Affiliation(s)
- Grayson Cole
- Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Angela Chi
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Science Center, El Paso, TX, USA
| | - Daniel R Cook
- Carolina Centers for Oral and Facial Surgery, Charlotte, NC, USA
| | - Mark Kubik
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Elizabeth A Bilodeau
- Department of Diagnostic Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Raja R Seethala
- Department of Pathology and Laboratory Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
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Awang Hasyim N, Ismail S, Ling XF, Tilakaratne WM. Odontogenic Carcinosarcoma: An Updated Literature Review and Report of a Case. Head Neck Pathol 2023; 17:731-738. [PMID: 36997684 PMCID: PMC10514253 DOI: 10.1007/s12105-023-01545-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/05/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Odontogenic carcinosarcoma (OCS) is an exceptionally rare malignant mixed odontogenic neoplasm, which mostly arises from recurrent benign odontogenic tumour that undergoes malignant transformation. METHODS A literature review was conducted using the keyword of "Odontogenic carcinosarcoma" and all relevant articles were screened. The data collected include demographic profile (age, gender), clinical information (symptoms, location, size), radiologic features, histopathological examination, management, recurrence, metastases, and survival status. RESULTS A total of 17 OCS cases including a new case from our hospital. The incidence of OCS was highest in the third decades of life with predilection for male and posterior region of mandible. Clinically, patients may present with swelling and neurological symptoms. Radiographic examination often showed radiolucency with ill-defined border. This tumour demonstrates an aggressive behaviour with reported cases of distant metastases to the lung, lymph nodes, rib, and pelvis. Here, we report an interesting case of OCS in a 38-year-old man with a previous diagnosis of ameloblastoma. The patient was diagnosed with ameloblastoma but refused surgical intervention and returned after 10 years with rapidly enlarging mass on the right side of mandible. Microscopically, the lesion appears as biphasic odontogenic tumour with malignant cytological features seen in both epithelium and mesenchymal components. The spindle to round mesenchymal tumour cells were only positive for vimentin. Ki67 proliferation index was high in both epithelium and mesenchymal components. CONCLUSION This case showed the tendency of untreated ameloblastoma to undergo malignant changes in the long term.
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Affiliation(s)
- Noratikah Awang Hasyim
- Oral Pathology and Oral Medicine Unit, Department of Oral and Maxillofacial Surgery, Hospital Sultan Abdul Halim, Ministry of Health, 08000, Sungai Petani, Kedah, Malaysia.
| | - Sumairi Ismail
- Oral Pathology and Oral Medicine Unit, Department of Oral and Maxillofacial Surgery, Hospital Sultan Abdul Halim, Ministry of Health, 08000, Sungai Petani, Kedah, Malaysia
| | - Xiao Feng Ling
- Department of Oral and Maxillofacial Surgery, Hospital Sultan Abdul Halim, Ministry of Health, Sungai Petani, Malaysia
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Villegas KM, Paparella ML. Malignant odontogenic tumors. A report of a series of 30 cases and review of the literature. Oral Oncol 2022; 134:106068. [PMID: 36099797 DOI: 10.1016/j.oraloncology.2022.106068] [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: 12/02/2021] [Revised: 07/19/2022] [Accepted: 08/06/2022] [Indexed: 11/16/2022]
Abstract
Malignant odontogenic tumors are rare entities and can arise de novo or from malignant transformation of pre-existing lesions. The aim of the present study was to report 30 cases of malignant odontogenic tumors diagnosed at a single diagnostic center over a 38-year period. MATERIALS AND METHODS All cases of malignant odontogenic tumors diagnosed between 1980 and 2018 were retrieved from the files of the School of Dentistry, University of Buenos Aires; their frequency and clinical, radiographic, and histopathological features were analyzed. The obtained data were compared with the information reported in the literature. RESULTS Malignant odontogenic tumors accounted for 2 % of odontogenic tumors and 0.05 % of all oral-maxillofacial diseases. Mean age was 43 years (8 to 87 years). No differences in sex distribution were observed. The most frequent location was the mandible, mostly the posterior mandibular body and the ramus. Odontogenic carcinomas were the most frequent tumors, and primary intraosseous carcinomas were the most common in this group. CONCLUSIONS This is the largest case series of malignant odontogenic tumors diagnosed at a single center reported in the literature to date. Diagnosis of these tumors is challenging based on their rarity and complexity and relies on careful analysis of the histopathological, clinical, and radiographic features.
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Affiliation(s)
- Krissya María Villegas
- Surgical Pathology Laboratory, Oral Pathology Department, Facultad de Odontología, Universidad de Buenos Aires. M.T. Alvear 2142, (C1122AAH) Buenos Aires, Argentina.
| | - María Luisa Paparella
- Surgical Pathology Laboratory, Oral Pathology Department, Facultad de Odontología, Universidad de Buenos Aires. M.T. Alvear 2142, (C1122AAH) Buenos Aires, Argentina.
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Majumdar S, Uppala D, Sreekanth K, Alekhya B. Odontogenic carcinosarcoma - A rare case report with review of literature. J Oral Maxillofac Pathol 2022; 26:S51-S58. [PMID: 35450233 PMCID: PMC9017839 DOI: 10.4103/jomfp.jomfp_408_20] [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] [Received: 10/02/2020] [Revised: 08/04/2021] [Accepted: 11/10/2021] [Indexed: 11/04/2022] Open
Abstract
Odontogenic carcinosarcoma (OCS) is a rare malignant odontogenic tumor (OT) with only a few cases reported in the literature. Its synonyms are ameloblastic carcinosarcoma, malignant mixed OT. It is characterized by a true mixed tumor showing malignant cytology of both epithelial and mesenchymal components. The tumor invaded into adjacent tissues by destroying the bone. A 24-year-old patient visited the outpatient clinic of GITAM Dental College and Hospital, with a chief complaint of growth in the lower right back tooth region for 6 months. Based on clinical and radiographic features, it has been diagnosed as an aggressive central jaw lesion. The patient was further referred for histological examination for confirmatory diagnosis. It has been diagnosed as an adenomatoid OT. The OCS most commonly affects the posterior part of the mandible. A larger number of cases were reported recently, and prolonged follow-up is needed to further clarify the nature of OCS.
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Affiliation(s)
- Sumit Majumdar
- Department of Oral Pathology and Microbiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Divya Uppala
- Department of Oral Pathology and Microbiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Kotina Sreekanth
- Department of Oral Pathology and Microbiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Bandi Alekhya
- Department of Oral Pathology and Microbiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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Haefliger S, Andrei V, Baumhoer D. Update of Key Clinical, Histological and Molecular Features of Malignant Bone Tumours Arising in the Craniofacial Skeleton. Front Oncol 2022; 12:954717. [PMID: 35875137 PMCID: PMC9301068 DOI: 10.3389/fonc.2022.954717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/15/2022] [Indexed: 02/05/2023] Open
Abstract
The craniofacial skeleton is a highly complex and specialized anatomic region containing and protecting the brain and sensory organs. Bone sarcomas arising here comprise a heterogeneous group of tumours, some of which differ in their biological behaviour compared to their peripheral counterparts. The reasons for this seem to lie, at least partially, in the embryonal development of the craniofacial bones. For reaching the correct diagnosis as the cornerstone of optimal personalised treatment planning, a multidisciplinary team of specialists, including pathologists, radiologists, oncologists, and head and neck surgeons needs to be involved. The most common tumours arising in the craniofacial bones are bone-forming tumours, cartilage-forming tumours, fibro-osseous lesions, giant cell-rich lesions, and notochordal tumours. While morphology remains the backbone for the diagnosis, the last decade has witnessed tremendous advances in the molecular characterization of tumours, and molecular testing is increasingly becoming a part of the diagnostic process. The integration of these new molecular markers into the diagnostic approach has undoubtedly increased the diagnostic accuracy and objectivity, and holds great promise to also identify new therapeutic targets for precision medicine in the future. Examples include HEY1-NCOA2 in mesenchymal chondrosarcoma, IDH1/2 mutations in chondrosarcoma and TFCP2 rearrangements in rhabdomyosarcoma. In this article, key clinical, histological and molecular features of malignant bone tumours arising in the craniofacial region are discussed, with a special focus on the differential diagnosis and prognostic considerations.
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Marin C, Dave M, Hunter KD. Malignant Odontogenic Tumours: A Systematic Review of Cases Reported in Literature. FRONTIERS IN ORAL HEALTH 2021; 2:775707. [PMID: 35048074 PMCID: PMC8757763 DOI: 10.3389/froh.2021.775707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Malignant odontogenic tumours (MOTs) arise either de novo from the tooth forming tissues, their developmental residues or from existing odontogenic epithelial or mesenchymal neoplasms in the jaws. Their management requires extensive surgery due to their infiltrative nature and risk of metastasis. There is a need to understand the clinical and pathological features of MOTs to inform both treatment algorithms and prognostication. This is an area of diagnostic pathology which presents substantial difficulties in diagnosis, compounded by inconsistent use of terminology. Thus, this systematic review aimed to describe the clinical and pathological features of MOTs with a view to consolidating the literature and defining problematic areas in diagnosis and classification. Methods: An electronic database search was conducted in Web of Science, PubMed/Medline, and Embase. Additionally, the grey literature and reference lists of selected papers searched for completeness. Nine hundred and sixty articles were initially identified. Following removal of duplicates and application of inclusion/exclusion criteria, 312 articles were included for qualitative analysis. Results: The 312 articles encompassed a total of 507 patients with most lesions located within the mandible (74.3%). The most common first histological diagnosis was ameloblastic carcinoma (25.7% of all diagnoses), but there is considerable variation in how and when various diagnostic terms are used, and several misdiagnoses were reported. An initial benign diagnosis was made in 24.7% of patients, followed by a later malignant diagnosis and in this sub-group, the most common benign first diagnosis was ameloblastoma (42.4%). Cervical lymph nodes were the most common site of metastasis (9.3% of patients). With respect to distant metastasis (DM), the lungs were the most common organ affected (11.2% of DM patients) with metastasising ameloblastoma the most commonly reported tumour which metastasised to the lungs. Overall, 26.8% of patients developed recurrence. Conclusion: Overall, the quality of the literature on MOTs is poor. This review of the literature has highlighted variations in diagnostic terms and criteria which has resulted in areas of confusion with potential for misdiagnosis. This consolidation of primary data has identified key areas for targeted research including further discussion on the malignant potential of ameloblastoma.
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Affiliation(s)
- Constanza Marin
- Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, University of Sheffield, Sheffield, United Kingdom
- Unidad de Patología y Medicina Oral, Facultad de Odontología, Universidad Andres Bello, Viña del Mar, Chile
| | - Manas Dave
- Division of Dentistry, The University of Manchester, Manchester, United Kingdom
| | - Keith D. Hunter
- Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, University of Sheffield, Sheffield, United Kingdom
- Department of Oral Pathology and Biology, School of Dentistry, University of Pretoria, Pretoria, South Africa
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Niu X, Huang B, Yang J, Qiao X, Chen L, Liu J, Xu J, Zhong M. Odontogenic carcinosarcoma with dentinoid: a rare case report. J Int Med Res 2021; 49:3000605211045555. [PMID: 34586932 PMCID: PMC8485321 DOI: 10.1177/03000605211045555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Odontogenic carcinosarcoma is a very rare malignant odontogenic tumor, characterized by malignant epithelial and mesenchymal components. Studies have reported several cases of odontogenic carcinosarcoma, mainly in the upper and lower jaws, with malignant clinical manifestations. Herein, we present the case of a 58-year-old woman with odontogenic carcinosarcoma with dentinoid in the left maxilla. The invasion range was large, and the left maxillary molar was missing. Histology revealed odontogenic carcinosarcoma with bidirectional differentiation characteristics and comprising three components: malignant epithelium, malignant interstitium, and dentinoid. The patient subsequently underwent nasal endoscopic sinus tumor resection, and she recovered well after surgery. After a strict 4-year follow-up, to date, there are still no signs of disease or local recurrence. To our knowledge, this is the first reported case of odontogenic carcinosarcoma with dentinoid. Our study describes the clinical, morphological, and immunohistochemical characteristics of this case, and distinguishes it from related diseases.
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Affiliation(s)
- Xing Niu
- Department of Stomatology, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Biying Huang
- Department of Oral Histopathology, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, Liaoning, China
| | - Jing Yang
- Department of Pathology, 457651First Affiliated Hospital of Jinzhou Medical University, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Xue Qiao
- Department of Central Laboratory, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, Liaoning, China
| | - Lijie Chen
- Department of Stomatology, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Jinwen Liu
- Department of Oral Histopathology, School and Hospital of Stomatology, China Medical University, Liaoning Province Key Laboratory of Oral Disease, Shenyang, Liaoning, China
| | - Jingping Xu
- Department of Stomatology, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
| | - Ming Zhong
- Department of Stomatology, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, China
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de Arruda JAA, Arantes DAC, Schuch LF, Mosconi C, Abreu LG, de Andrade BAB, Romañach MJ, Mesquita RA, Silva TA, Batista AC, Mendonça EF. A Rare Case of an Aggressive Clear Cell Variant of Calcifying Epithelial Odontogenic Tumor in the Posterior Maxilla. Int J Surg Pathol 2020; 28:526-535. [PMID: 31986944 DOI: 10.1177/1066896920901755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
A clear cell variant of calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm, accounting for 33 cases described in the literature. In this article, we report a challenging example of clear cell variant of calcifying epithelial odontogenic tumor of the posterior maxilla in a 45-year-old female patient showing locally aggressive growth and recurrence. Microscopically, islands of polyhedral cells containing abundant cytoplasm, well-developed intercellular bridges blended with clear cells were observed. The nuclei were frequently pleomorphic and permeated by hyaline calcified material. Immunohistochemistry revealed positivity for pan-cytokeratin (AE1/AE3), cytokeratins (CK-14 and CK-19), Bcl-2, p53, and p63. The Ki-67 proliferative index was ~10%. As odontogenic tumors are rare, when a significant clear cell component is observed, the differential diagnosis with other lesions of the jaws with similar morphology, including other odontogenic tumors with prominent clear cell component, clear cell odontogenic carcinomas, and metastatic tumors, is difficult.
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Affiliation(s)
| | | | | | - Carla Mosconi
- Universidade Federal de Goiás, Goiânia, Goiás, Brazil
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Soares CD, Delgado-Azañero W, Morais TMDL, de Almeida OP, Ghersi Miranda H. Odontogenic Carcinosarcoma: Clinicopathologic Features of 2 Cases. Int J Surg Pathol 2019; 28:421-426. [PMID: 31786969 DOI: 10.1177/1066896919888578] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study reports 2 odontogenic carcinosarcomas, including the clinicopathologic and immunoprofile characteristics of these rare tumors. The first case occurred in a 22-year-old male presenting a bilobular mass involving the gingiva and bone of the premolar region of the left mandible, with paresthesia of the lower lip. Microscopic examination revealed a tumor similar to ameloblastic fibrosarcoma, with atypical mesenchymal cells; however, the odontogenic epithelium also showed atypia. In the second case, a 16-year-old female had a painless, asymptomatic, large intraosseous mandibular lesion. The patient received radiotherapy to treat a rhabdomyosarcoma of the parotid 13 years before. The tumor was composed of atypical spindle cells, positive for vimentin and smooth muscle actin, intermingled with malignant odontogenic epithelium. Both epithelial and mesenchymal components of the tumors showed high index of p53- and Ki67-positive cells. The first case was diagnosed as odontogenic carcinosarcoma possibly originated from an ameloblastic fibrosarcoma, and the second as de novo odontogenic carcinosarcoma possibly caused by previous radiotherapy.
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