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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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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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Breik O, Higginson J, Al-Ajami AK, Mohamed A, Martin T, Amel-Kashipaz R. Clear Cell Odontogenic Carcinoma: First Report of Novel EWSR1-CREM Fusion Gene in Case of Long-Term Misdiagnosis. Head Neck Pathol 2021; 15:1391-1398. [PMID: 33616852 PMCID: PMC8633255 DOI: 10.1007/s12105-021-01302-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 02/05/2021] [Indexed: 01/11/2023]
Abstract
Clear Cell odontogenic Carcinomas (CCOC) are rare, aggressive malignant odontogenic tumours which are often misdiagnosed as benign odontogenic tumours due to the non-specific histologic appearance, and benign early clinical presentation. However, due to their propensity to metastasize, the best outcomes are experienced with they are diagnosed early and treated aggressively. In this paper, we present a case of a CCOC misdiagnosed as a clear cell calcifying epithelial odontogenic tumour which was only found to be a CCOC after cervical node metastasis. The original diagnosis was questioned and confirmed to be a CCOC by identification of the chromosomal translocation EWSR1 on fluorescence in situ hybridization. This has recently been described in CCOC and a wide variety of other mesenchymal and epithelial neoplasms. Previous reports have demonstrated EWSR1-ATF1 and EWSR1-CREB1 fusions in CCOC. Next generation sequencing of this case demonstrated the EWSR1-CREM fusion gene which has not been previously reported for CCOC. CREM fusion proteins have only recently been found in several tumour types including the closely associated hyalinizing clear cell carcinoma of salivary glands. This is discussed in this paper, and the role of the discovery of the CREM fusion protein in CCOC adds to your understating of the role of CREM in oncogenesis, and the possible link between CCOCs and hyalinizing clear cell carcinomas.
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Affiliation(s)
- Omar Breik
- Head and Neck Surgeon, Oral and Maxillofacial Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK
| | - James Higginson
- Oral and Maxillofacial Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK
| | - Abdulla K. Al-Ajami
- Oral and Maxillofacial Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK
| | - Abubakar Mohamed
- Biomedical Science, Molecular Pathology, Queen Elizabeth Hospital, Birmingham, UK
| | - Tim Martin
- Head and Neck Surgeon, Oral and Maxillofacial Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK
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4
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Patankar SA, Raut P, Patankar AP, Kshirsagar RA. Clear cell odontogenic carcinoma in maxilla: A rare case report. J Oral Maxillofac Pathol 2020; 24:590. [PMID: 33967522 PMCID: PMC8083418 DOI: 10.4103/jomfp.jomfp_298_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: 07/16/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 11/04/2022] Open
Abstract
A rare and aggressive form of tumor with a female predilection and more seen with mandible is the clear cell odontogenic carcinoma (CCOC). The World Health Organization categorized it as a malignant neoplasm in 2005. This type of tumor is characterized by local recurrences as well as distant metastasis apart from being highly aggressive in nature. Due to the presence of clear cells, it is a diagnostic challenge to the pathologist. Only about 84 cases of maxillary variant have been reported in the literature. Here, we present a case report of a 31-year-old male with CCOC in the maxilla from the pathological and diagnostic point of view.
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Affiliation(s)
- Swapna Amod Patankar
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| | - Pratik Raut
- Department of Consultant Maxillofacial Surgeon in Pune, Pune, Maharashtra, India
| | - Amod Pramod Patankar
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
| | - Rajesh Ashok Kshirsagar
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
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Guastaldi FPS, Faquin WC, Gootkind F, Hashemi S, August M, Iafrate AJ, Rivera MN, Kaban LB, Jaquinet A, Troulis MJ. Clear cell odontogenic carcinoma: a rare jaw tumor. A summary of 107 reported cases. Int J Oral Maxillofac Surg 2019; 48:1405-1410. [PMID: 31227275 DOI: 10.1016/j.ijom.2019.05.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/22/2019] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to summarize the currently published cases of clear cell odontogenic carcinoma (CCOC). The PubMed and Springer databases were used to collect available reports, searching for 'clear cell odontogenic carcinoma', 'CCOC', or 'clear cell ameloblastoma'. The search resulted in 75 reports detailing 107 cases between 1985 and 2018. Clinically the tumor manifests as a swelling in the posterior mandible (n=46), anterior mandible (n=33), and maxilla (n=28). Radiological analysis of 85 cases typically showed a poorly defined expansive radiolucency (n=83). Of the 70 patients with symptoms reported, 44 specified a swelling, 11 tooth mobility, seven gingival/periodontal issues, five numbness, and three decreased jaw opening. One patient presented with a neck mass. The duration of symptoms prior to seeking care was specified for 52 patients: 2 months to 1 year for 34 patients, 1-2 years for seven, 2-4 years for two, 4-7 years for six, and 7-12 years for three. The incidence of recurrence appeared to be 38 of the 88 cases where recurrence was reported. CCOC can be distinguished from other oral cancers by its distinctive histology and immunohistochemical characteristics and less aggressive behavior. Currently, treatment should be early and aggressive resection with clear surgical margins and long-term follow-up. The overall goal is to collect a cohort of patients.
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Affiliation(s)
- F P S Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - W C Faquin
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - F Gootkind
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - S Hashemi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - M August
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - A J Iafrate
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - M N Rivera
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - L B Kaban
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | | | - M J Troulis
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA.
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Ferreira S, Faverani LP, Santos GMD, Martins EP, Garcia Júnior IR. Clear cell odontogenic carcinoma of the mandible: a treatment strategy. J Appl Oral Sci 2018; 26:e20160645. [PMID: 29340482 PMCID: PMC5777409 DOI: 10.1590/1678-7757-2016-0645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/08/2017] [Indexed: 11/22/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine. Incisional biopsy analysis indicated a diagnosis of CCOC. The treatment proposed was segmental resection of the mandible with a safety margin. After six months without recurrence, definitive mandibular reconstruction was performed using an iliac crest graft, followed by rehabilitation with implant-supported denture after five months. After three years of post-resection follow-up, the patient has shown no evidence of recurrence or metastasis. She continues to be under follow-up. To conclude, CCOC must be considered a malignant tumor with aggressive behavior. Previous studies have shown that resection with free margins is a treatment with a lower rate of recurrence. Nevertheless, long-term follow-up is necessary for such patients.
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Affiliation(s)
- Sabrina Ferreira
- Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, SP, Brasil
| | - Leonardo Perez Faverani
- Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, SP, Brasil
| | - Gabriel Mulinari Dos Santos
- Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, SP, Brasil
| | | | - Idelmo Rangel Garcia Júnior
- Univ. Estadual Paulista, Faculdade de Odontologia de Araçatuba, Departamento de Cirurgia e Clínica Integrada, Araçatuba, SP, Brasil
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7
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Yazici ZM, Mete O, Elmalı Z, Sayin İ, Yilmazer R, Kayhan FT. Clear Cell Odontogenic Carcinoma of the Maxilla. ACTA MEDICA (HRADEC KRÁLOVÉ) 2016; 54:122-4. [DOI: 10.14712/18059694.2016.33] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis and low survival. We report a case of CCOC affecting the maxilla of 62 year-old woman. It was first described as a clinicopathological entity in 1985 and to date only 67 cases were described in the English literature. We are understanding of the behavior of this carcinomas was depend on limited case reports. For these reason we found important to report this case of CCOC in the maxilla.
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8
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Loyola AM, Cardoso SV, de Faria PR, Servato JPS, Barbosa de Paulo LF, Eisenberg ALA, Dias FL, Gomes CC, Gomez RS. Clear cell odontogenic carcinoma: report of 7 new cases and systematic review of the current knowledge. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:483-96. [PMID: 26232924 DOI: 10.1016/j.oooo.2015.06.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 05/29/2015] [Accepted: 06/01/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The goal of this study is to describe 7 cases of clear cell odontogenic carcinoma among a Brazilian population and compare these data with a systematic review of the English-language literature. STUDY DESIGN Descriptive statististics were used to compare the clinicopathologic data gathered retrospectively with those compiled from a review. Tumor sections were immunostained for Ki-67, p16, p53, and cytokeratins (CKs) 7, 8, 14, 18, and 19. Log-rank tests were performed for survival analysis. RESULTS Most cases occurred in the posterior mandible (5/7, 71.4%), and recurrence was diagnosed in all treated patients. Metastatic disease occurred in 2 patients (28.6%). Tumors were focally positive for CKs 7, 8, 14, and 18 and diffusely positive for CK19, p53, and p16. The mean number of Ki-67-positive cells was 35.2 cells/high-power field. Our systematic review provided evidence that tumor size (P = .046), histologic pattern (P = .034), regional metastasis (P = .001), distant metastasis (P = .001), and local recurrence (P = .05) were of significant prognostic value. CONCLUSIONS This study has contributed to improved characterization of clear cell odontogenic carcinoma, which is an aggressive odontogenic malignant neoplasm diagnosed mainly in the posterior mandible of middle-aged women and typically at an advanced stage. Radical surgical procedures remain the gold standard treatment.
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Affiliation(s)
- Adriano Mota Loyola
- Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia, Uberlândia (MG), Brazil.
| | - Sergio Vitorino Cardoso
- Department of Morphology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia (MG), Brazil
| | - Paulo Rogério de Faria
- Department of Morphology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia (MG), Brazil
| | - João Paulo Silva Servato
- Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia, Uberlândia (MG), Brazil
| | | | | | - Fernando Luiz Dias
- Division of Head and Neck Surgery, Brazilian National Institute of Cancer, Rio de Janeiro (RJ), Brazil
| | | | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
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Swain N, Dhariwal R, Ray JG. Clear cell odontogenic carcinoma of maxilla: A case report and mini review. J Oral Maxillofac Pathol 2013; 17:89-94. [PMID: 23798837 PMCID: PMC3687196 DOI: 10.4103/0973-029x.110681] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring predominantly in posterior mandible during 5th-7th decades with a female predilection. It is a potentially aggressive tumor, capable of frequent recurrences and loco-regional and distant metastases. Till date, only 73 cases have been reported in the literature. Current case is of a 55-year-old woman with tumor mass extending from canine to molar region on the left maxillary arch. Being locally aggressive tumor with the capacity to metastasize, it demands to be distinguished from other primary and metastatic clear cell tumors of the oral and maxillofacial region. A brief compilation of the reported cases is being attempted in the current article to better understand the behavior of the tumor.
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Affiliation(s)
- Niharika Swain
- Department of Oral Pathology, M.G.M. Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Affiliation(s)
- Lee J Slater
- Scripps Oral Pathology Service, 5190 Governor Drive, Suite 106 San Diego, CA 92122-2848, USA
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11
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Hutton SB, Kalamchi S, Wright JM. An incidentally discovered radiolucency in the posterior mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:17-20. [PMID: 22669064 DOI: 10.1016/j.tripleo.2011.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 07/27/2011] [Accepted: 08/03/2011] [Indexed: 10/14/2022]
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12
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Woo SB. Odontogenic Tumors. ORAL PATHOLOGY 2012:340-381. [DOI: 10.1016/b978-1-4377-2226-0.00015-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Abstract
Clear cell differentiation in unicystic ameloblastoma with inclusion of many other histologic variants in the same tumor is a very rare occurrence. Here, we report a case of a well-circumscribed large mandibular swelling in a 22 - year old female. The lesion was histopathologically diagnosed as unicystic ameloblastoma which showed multiple histologic patterns and clear cell differentiation. The tumor was treated with surgical enucleation and chemical cauterization. A follow up of 20 months has shown no recurrence after initial surgery.
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Affiliation(s)
- MB Radhika
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, MVIT Campus, Near Yelahanka, Hunusamaranahalli, Bangalore, India
| | - Lalita J Thambiah
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, MVIT Campus, Near Yelahanka, Hunusamaranahalli, Bangalore, India
| | - K Paremala
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, MVIT Campus, Near Yelahanka, Hunusamaranahalli, Bangalore, India
| | - M Sudhakara
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, MVIT Campus, Near Yelahanka, Hunusamaranahalli, Bangalore, India
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Zhang J, Liu L, Pan J, Tian X, Tan J, Zhou J, Duan Y. Clear cell odontogenic carcinoma: report of 6 cases and review of the literature. Med Oncol 2010; 28 Suppl 1:S626-33. [DOI: 10.1007/s12032-010-9668-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2010] [Accepted: 08/18/2010] [Indexed: 10/19/2022]
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15
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Clear-Cell Odontogenic Carcinoma: A New Case and Long-Term Follow-Up of an Old Case, and Review of the Literature. J Oral Maxillofac Surg 2009; 67:1342-8. [DOI: 10.1016/j.joms.2008.06.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Revised: 03/02/2008] [Accepted: 06/16/2008] [Indexed: 11/21/2022]
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16
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Chaine A, Pitak-Arnnop P, Dhanuthai K, Bertrand JC, Bertolus C. An asymptomatic radiolucent lesion of the maxilla. Clear cell odontogenic carcinoma. ACTA ACUST UNITED AC 2008; 107:452-7. [PMID: 19071036 DOI: 10.1016/j.tripleo.2008.09.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2008] [Revised: 09/06/2008] [Accepted: 09/09/2008] [Indexed: 11/19/2022]
Affiliation(s)
- André Chaine
- Department of Maxillofacial Surgery, AP-HP, Pitié-Salpêtrière University Hospital, Faculty of Medicine, University Paris 6 (Pierre et Marie Curie), Paris, France
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17
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Gasparini G, Boniello R, Moro A, Federico F, Castri F, Pelo S. Unusual clear cell tumors of the jaws - clinical and histopathological considerations: a case report. J Med Case Rep 2008; 2:290. [PMID: 18761743 PMCID: PMC2553086 DOI: 10.1186/1752-1947-2-290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2008] [Accepted: 09/01/2008] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Clear cell neoplasms of the jaw are very infrequent and a review of the literature reports only isolated cases of metastatic renal clear cell carcinoma of the jaw. CASE PRESENTATION A 68-year-old man presented with an osteolytic lesion of the left hemimandible. The first diagnostic hypothesis was a third molar follicular cyst. Surgical treatment consisted of enucleating the lesion preserving the alveolar nerve and extracting of the retained tooth. Unexpectedly, the lesion presented as a solid. CONCLUSION The authors report a case of a clear cell neoplasm involving the jaw in which histopathological exam presented an indeterminate histology. The histological characteristics of this tumor make it unique in the international literature.
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Affiliation(s)
- Giulio Gasparini
- Maxillo-Facial Surgery, Catholic University Medical School, Rome, Italy.
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18
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Xavier FCA, Rodini CO, Ramalho LMP, Sarmento VA, Nunes FD, de Sousa SCOM. Clear cell odontogenic carcinoma: case report with immunohistochemical findings adding support to the challenging diagnosis. ACTA ACUST UNITED AC 2008; 106:403-10. [PMID: 18602308 DOI: 10.1016/j.tripleo.2008.03.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 02/08/2008] [Accepted: 03/10/2008] [Indexed: 11/19/2022]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis, and low survival. We report a case of CCOC affecting the mandible of a 39-year-old man. The tumor presented a biphasic pattern composed of clear cell nests intermingled with eosinophilic cells and separated by collagenous stroma. Immunoreactivity to cytokeratin (CK), specifically AE1/AE3 and CK 8, 14, 18, and 19 was found, as well as to epithelial membrane antigen (EMA). The tumor cells were negative for S100 protein, CK 13, vimentin, smooth muscle actin, laminin and type IV collagen. Low labeling indices for the proliferation markers Ki-67 and proliferating cell nuclear antigen and to p53 protein might predict a favorable prognosis for the lesion. A surgical resection was performed, followed by adjuvant radiotherapy. A 2-year follow-up has shown no signs of recurrence. The significance of histochemical and immunohistochemical resources in the correct diagnosis of CCOC is analyzed.
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Abstract
Malignant odontogenic tumors are extremely rare. As with benign odontogenic tumors, malignant epithelial odontogenic tumors or odontogenic carcinomas are distinguished from the even rarer mesenchymal ones, the odontogenic sarcomas. The existence of odontogenic carcinosarcomas is not yet acknowledged by the World Health Organization. Odontogenic carcinomas comprise ameloblastic carcinoma (AmCa), primary intraosseous carcinoma (PIOC), clear cell odontogenic carcinoma, odontogenic ghost cell carcinoma (OGCC), and the special case of metastasizing ameloblastoma. Odontogenic sarcomas consist of ameloblastic fibrosarcoma and ameloblastic fibrodentinosarcoma and fibroodontosarcoma. Whereas metastasizing ameloblastoma can be diagnosed only after having metastasized, all other malignant odontogenic tumors present with atypia, increased cellularity and mitoses, and invasion. Odontogenic sarcomas are regarded as low-grade tumors that rarely metastasize. Odontogenic carcinomas, however, especially AmCa, OGCC, and PIOC, are more aggressive, with a 5-year survival rate of about 70% for AmCa and OGCC and a 3-year survival rate of about 37% for PIOC. Radical surgery, eventually in combination with radiotherapy, is the treatment of choice.
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Affiliation(s)
- G Jundt
- Institut für Pathologie, DÖSAK-Zentralregister am Knochentumor-Referenzzentrum, Universitätsspital Basel, Schweiz.
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