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Sharma K, Chauhan A, Sharma P, Wadhwan V, Tyagi S, Sharma R. Clear cell oral squamous cell carcinoma as a diagnostic conundrum: report of 2 rare cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:e83-e90. [PMID: 38281881 DOI: 10.1016/j.oooo.2023.12.784] [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: 08/17/2023] [Revised: 11/22/2023] [Accepted: 12/10/2023] [Indexed: 01/30/2024]
Abstract
The occurrence of clear cell histologic sub-type of oral squamous cell carcinoma in the oral cavity is a distinct and exceedingly rare entity exhibiting aggressive behavior. To date, only 10 cases have been published in the literature. We describe 2 extremely rare cases, both presenting with swelling and ulcerated nodule-like proliferative growth in the mandible. Microscopically, sheets and lobules of neoplastic squamous epithelial cells showing clear cell differentiation were appreciated in both patients. Periodic acid-Schiff and mucicarmine revealed negative staining. Immunohistochemical (IHC) analysis for antibody for renal cell tumor marker CD 10 was immune-negative. The malignant clear cells in both cases showed intense positive reactions with IHC markers pan-cytokeratin and epithelial membrane antigen, confirming the diagnosis as a clear cell variant of oral squamous cell carcinoma (CCOSCC). The first patient was unwilling for treatment and eventually died within 2 months of the diagnosis. In the second patient, right hemi-mandibulectomy with level 1A and 1B lymph nodes was performed. Adjuvant chemotherapy with low-dose methotrexate was initiated. Follow-up after 2 months of surgery was uneventful. Current rare reports emphasize the significance of prompt and extensive diagnostic work-up of clear cell neoplasms, as the CCOSCC may be fatal.
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Affiliation(s)
- Kush Sharma
- Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Anindita Chauhan
- Subharti Medical College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Preeti Sharma
- Department of Oral & Maxillofacial Pathology & Oral Microbiology, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India.
| | - Vijay Wadhwan
- Department of Oral & Maxillofacial Pathology & Oral Microbiology, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Sonam Tyagi
- Department of Oral & Maxillofacial Pathology & Oral Microbiology, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Rishabh Sharma
- Kasturba Medical College, Manipal, Manipal 576104, Karnataka, India
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2
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Penafort PVM, Roza ALOC, Kussaba ST, de Brot Andrade L, Pinto CAL, Vargas PA. Exuberant clear cell odontogenic carcinoma of the mandible harboring EWSR1 rearrangement: Report of a rare case and a literature review. Oral Oncol 2023; 143:106462. [PMID: 37331036 DOI: 10.1016/j.oraloncology.2023.106462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/11/2023] [Indexed: 06/20/2023]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic tumour (MOT) that mainly affects the mandible, with a slight female predominance in adult patients. In this study, we described an exuberant CCOC in mandible of a 22-year-female patient. On radiographic examination, a radiolucent lesion in the region of tooth 36 to 44 with tooth displacement and alveolar cortical resorption was observed. Histopathological study revealed a malignant neoplasm of the odontogenic epithelium, composed of PAS-positive clear cells and immunoreactivity for CK5, CK7, CK19, p63. The Ki-67 index was low (<10 %). Fluorescent in situ hybridization revealed EWSR1 gene rearrangement. The diagnosis of CCOC was established and the patient was referred for surgical treatment.
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Affiliation(s)
| | | | | | | | | | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil.
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3
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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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Ramani P, Gheena S, Karunagaran M, Hannah R. Clear-cell variant of oral squamous cell carcinoma: A rare entity. J Oral Maxillofac Pathol 2021; 25:S22-S26. [PMID: 34083965 PMCID: PMC8123239 DOI: 10.4103/jomfp.jomfp_295_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/25/2020] [Accepted: 01/29/2021] [Indexed: 12/02/2022] Open
Abstract
Clear-cell variant of oral squamous cell carcinoma is an extremely rare entity in the maxillofacial region. We report a case of 42-year-old female who presented with a soft-tissue growth with erythematous and nonscrapable irregular white patches on the left alveolar mucosa for the past 3 months. Histopathologic examination showed lobules and sheets of clear cells with features of malignancy extending from the surface epithelium. Periodic acid–Schiff and mucicarmine stains showed a negative reaction. Immunohistochemical study using antibody for pan-cytokeratin revealed intense positivity and negative for the markers such as S-100, smooth muscle actin and CD 117.
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Affiliation(s)
- Pratibha Ramani
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospital, SIMATS University, Chennai, Tamil Nadu, India
| | - S Gheena
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospital, SIMATS University, Chennai, Tamil Nadu, India
| | - Monika Karunagaran
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospital, SIMATS University, Chennai, Tamil Nadu, India
| | - R Hannah
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospital, SIMATS University, Chennai, Tamil Nadu, India
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Jannu A, Rao G, Kulambi M, Talkal AK, Suma MS, Deepa KK, Srinivas R. Clear cell odontogenic carcinoma of maxilla: A rare case report. Natl J Maxillofac Surg 2021; 12:124-127. [PMID: 34188415 PMCID: PMC8191545 DOI: 10.4103/njms.njms_102_19] [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: 12/31/2019] [Revised: 02/13/2020] [Accepted: 04/28/2020] [Indexed: 11/25/2022] Open
Abstract
Clear cell odontogenic carcinoma is a rare, infrequent, aggressive in nature, locally reoccurring odontogenic tumor with a tendency of distant metastasis, occurring during to 4th to 6th decades with a mostly female predilection. Histologically, it is characterized by sheets and islands of vacuolated/clear cells. Till date, only 74 cases have been reported in the literature. We present a case of 45-year-old woman with a tumor mass extending from the maxillary right first premolar till the third molar region measuring 4 cm × 4 cm. The diagnosis was given based on the histopathological findings. Being locally aggressive, the reported data and understanding of this infrequent tumor needs to be strengthened by reporting new cases, and it also demands to be distinguished from other primary and metastatic clear cell tumors of the head-and-neck region.
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Affiliation(s)
- Anubhav Jannu
- Department of Oral and Maxillofacial Surgery, Subbaiah Institute of Medical and Dental Sciences, Shimoga, Karnataka, India
| | - Gautam Rao
- Department of Oral and Maxillofacial Surgery, Subbaiah Institute of Medical and Dental Sciences, Shimoga, Karnataka, India
| | - Mithun Kulambi
- Department of Oral and Maxillofacial Pathology, Subbaiah Institute of Medical and Dental Sciences, Shimoga, Karnataka, India
| | - Arun Kumar Talkal
- Department of Prosthodontics, Subbaiah Institute of Medical and Dental Sciences, Shimoga, Karnataka, India
| | - M S Suma
- Department of Oral Medicine and Radiology, Subbaiah Institute of Medical and Dental Sciences, Shimoga, Karnataka, India
| | - K K Deepa
- Department of Oral Pathology, Subbaiah Institute of Medical and Dental Sciences, Shimoga, Karnataka, India
| | - Rachana Srinivas
- Department of Pediatric Dentistry, Subbaiah Institute of Medical and Dental Sciences, Shimoga, Karnataka, India
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Seyiti P, Feng Y, Gao A, Lin Z, Huang X, Sun G, Zhang L, Wang T. An extensive sclerosing odontogenic carcinoma in mandible: a case report and literature review. Dentomaxillofac Radiol 2020; 49:20190426. [PMID: 32320271 DOI: 10.1259/dmfr.20190426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Sclerosing odontogenic carcinoma (SOC) is a primary intraosseous carcinoma of the jaw that was listed as a separate entity for the first time in the latest version of the World Health Organization classification of Head and Neck Tumors (2017). In this report, we present a case of SOC involving a circuitous diagnostic process because of the inadequately detailed biopsy findings and inherent impression based on the imaging manifestations. Through an extensive literature review, the histopathological and immunohistochemical features of the disease were briefly summarized. Radiological findings of SOC have been characterized in detail, and an imaging classification scheme has been proposed to further discuss the diversity of radiographic features. Due to the rarity of the disease, a comprehensive understanding of SOC is needed, and close collaboration between clinicians, radiologists, and pathologists is crucial to avoid misdiagnosis.
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Affiliation(s)
- Pakezhati Seyiti
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yinglian Feng
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Xiaofeng Huang
- Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Guowen Sun
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lei Zhang
- Department of Oral Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Tiemei Wang
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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8
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Guastaldi FPS, Faquin WC, Gootkind F, Hashemi S, August M, Iafrate AJ, Rivera MN, Kaban LB, Jaquinet A, Troulis MJ. Clear cell odontogenic carcinoma: a rare jaw tumor. A summary of 107 reported cases. Int J Oral Maxillofac Surg 2019; 48:1405-1410. [PMID: 31227275 DOI: 10.1016/j.ijom.2019.05.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 05/22/2019] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to summarize the currently published cases of clear cell odontogenic carcinoma (CCOC). The PubMed and Springer databases were used to collect available reports, searching for 'clear cell odontogenic carcinoma', 'CCOC', or 'clear cell ameloblastoma'. The search resulted in 75 reports detailing 107 cases between 1985 and 2018. Clinically the tumor manifests as a swelling in the posterior mandible (n=46), anterior mandible (n=33), and maxilla (n=28). Radiological analysis of 85 cases typically showed a poorly defined expansive radiolucency (n=83). Of the 70 patients with symptoms reported, 44 specified a swelling, 11 tooth mobility, seven gingival/periodontal issues, five numbness, and three decreased jaw opening. One patient presented with a neck mass. The duration of symptoms prior to seeking care was specified for 52 patients: 2 months to 1 year for 34 patients, 1-2 years for seven, 2-4 years for two, 4-7 years for six, and 7-12 years for three. The incidence of recurrence appeared to be 38 of the 88 cases where recurrence was reported. CCOC can be distinguished from other oral cancers by its distinctive histology and immunohistochemical characteristics and less aggressive behavior. Currently, treatment should be early and aggressive resection with clear surgical margins and long-term follow-up. The overall goal is to collect a cohort of patients.
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Affiliation(s)
- F P S Guastaldi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - W C Faquin
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - F Gootkind
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - S Hashemi
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - M August
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | - A J Iafrate
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - M N Rivera
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - L B Kaban
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA
| | | | - M J Troulis
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Harvard School of Dental Medicine, Boston, MA, USA.
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Upadhyay S, Bhavthankar JD, Mandale MS, Barewad B. Clear cell odontogenic carcinoma: Case report of a deceptive pathology. J Oral Maxillofac Pathol 2019; 23:140-143. [PMID: 31110431 PMCID: PMC6503774 DOI: 10.4103/jomfp.jomfp_78_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Clear cells are associated with numerous physiological and pathological conditions. Odontogenic cysts and tumors can arise from physiological clear cells like rests of dental lamina. One such clear cell neoplasm is clear cell odontogenic carcinoma (CCOC) that is associated with aggressive clinical behavior, metastasis and low survival rate. With <80 cases reported so far, it is a rare entity. Initially described as a clear cell odontogenic tumor considering it as a benign but invasive neoplasm, it was later termed as CCOC owing to its infiltrative nature with a marked tendency for local recurrence, regional nodal spread and possible distant, mainly pulmonary, metastasis. Reported here is a case of CCOC affecting mandible of a 55-year-old female along with its immunohistochemical workup.
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Affiliation(s)
- Sneha Upadhyay
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Jyoti D Bhavthankar
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Mandakini S Mandale
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Bhagyoday Barewad
- Department of Dentistry, S.R.T.R. Government Medical College, Ambajogai, Maharashtra, India
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Park JC, Kim SW, Baek YJ, Lee HG, Ryu MH, Hwang DS, Kim UK. Misdiagnosis of ameloblastoma in a patient with clear cell odontogenic carcinoma: a case report. J Korean Assoc Oral Maxillofac Surg 2019; 45:116-120. [PMID: 31106140 PMCID: PMC6502756 DOI: 10.5125/jkaoms.2019.45.2.116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/13/2017] [Accepted: 11/22/2017] [Indexed: 12/02/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC), a rare tumor in the head and neck region, displays comparable properties with other tumors clinically and pathologically. In consequence, an incorrect diagnosis may be established. A 51-year-old male patient who was admitted to the Department of Oral and Maxillofacial Surgery at Pusan National University Dental Hospital was initially diagnosed with ameloblastoma via incisional biopsy. However, the excised mass of the patient was observed to manifest histopathological characteristics of ameloblastic carcinoma. The lesion was ultimately diagnosed as clear cell odontogenic carcinoma by the Department of Oral Pathology of Pusan National Dental University. Therefore, segmental mandibulectomy and bilateral neck dissection were performed, followed by reconstruction with fibula free flap and reconstruction plate. Concomitant chemotherapy radiotherapy was not necessary. The patient has been followed up, and no recurrence has occurred 6 months after surgery.
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Affiliation(s)
- Jong-Cheol Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Seong-Won Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Young-Jae Baek
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Hyeong-Geun Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Mi-Heon Ryu
- Department of Oral Pathology, BK21 Plus Project, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Dae-Seok Hwang
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
| | - Uk-Kyu Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Korea
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11
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Odontogenic lesion mimicking squamous cell carcinoma: A new histological entity? ORAL AND MAXILLOFACIAL SURGERY CASES 2018. [DOI: 10.1016/j.omsc.2018.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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12
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Jain A, Shetty DC, Juneja S, Narwal N. Molecular Characterization of Clear Cell Lesions of Head and Neck. J Clin Diagn Res 2016; 10:ZE18-23. [PMID: 27437379 DOI: 10.7860/jcdr/2016/14394.7867] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 12/11/2015] [Indexed: 11/24/2022]
Abstract
The salivary glands, oral mucosa and jaws constitute a group of lesions which are heterogeneous in nature and are odontogenic, salivary or metastatic in origin. This group of tumours is termed as Clear Cell Tumours. Fixation artifacts are one of the most important reasons for the cell to appear clear but clearing of cells may also result from cytoplasmic accumulation of water, presence of glycogen within the cell, intermediate filaments, immature zymogen granules, or a paucity of cellular organelles. Clear cell Odontogenic neoplasms predominantly include odontogenic carcinoma, ameloblastoma and calcifying epithelial odontogenic tumour. Clear cell tumours of salivary gland origin are almost invariably malignant in nature but they do include two benign lesions. Very frequently, surgical pathologist encounters clear cells in many malignant neoplasms, the nature and sources of which are undetermined on the basis of conventional histopathology. This review will selectively discuss the clinicopathological features of neoplasms which at times may pose a diagnostic challenge and dilemma due to clear cell changes.
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Affiliation(s)
- Anshi Jain
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, I.T.S. Centre for Dental Studies and Research , Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Devi Charan Shetty
- Professor and Head, Department of Oral and Maxillofacial Pathology, I.T.S. Centre for Dental Studies and Research , Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Saurabh Juneja
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, I.T.S. Centre for Dental Studies and Research , Murad Nagar, Ghaziabad, Uttar Pradesh, India
| | - Nidhi Narwal
- Senior Lecturer, Department of Oral and Maxillofacial Pathology, I.T.S. Centre for Dental Studies and Research , Murad Nagar, Ghaziabad, Uttar Pradesh, India
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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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Abstract
This article presents various odontogenic cysts and tumors, including periapical cysts, dentigerous cysts, odontogenic keratocysts, orthokeratinized odontogenic cysts, lateral periodontal cysts, glandular odontogenic cysts, ameloblastomas, clear cell odontogenic carcinomas, adenomatoid odontogenic tumors, calcifying epithelial odontogenic tumors, squamous odontogenic tumors, ameloblastic fibromas, ameloblastic fibro-odontomas, odontomas, calcifying cystic odontogenic tumors, and odontogenic myxomas. The authors provide an overview of these cysts and tumors, with microsopic features, gross features, differential diagnosis, prognosis, and potential diagnostic pitfalls.
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Affiliation(s)
- Angela C Chi
- Division of Oral Pathology, Department of Stomatology, College of Dental Medicine, Medical University of South Carolina, MSC 507, 173 Ashley Avenue, Charleston, SC 29425, USA
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15
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Walia C, Chatterjee RP, Kundu S, Roy S. Clinical enigma: A rare case of clear cell odontogenic carcinoma. Contemp Clin Dent 2015; 6:559-63. [PMID: 26681866 PMCID: PMC4678559 DOI: 10.4103/0976-237x.169849] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Clear cell odontogenic carcinoma is a rare, aggressive neoplasm of the jaw with only 74 reported cases. It occurs predominantly in the mandibular anterior region during fifth to seventh decades of life. Clinically it manifests as intra-bony swelling with a variable degree of pain. Microscopically, it reveals nests of cells with clear cytoplasm in connective tissue stroma arranged in different patterns. It is often misdiagnosed due to the rarity of lesion and confusing histopathology. Immunohistochemical staining plays an intricate role to uncertain the native of the clear cell to reach a confirmative diagnosis. The article aims to highlight the clinicopathologic features of clear cell odontogenic carcinoma in a middle-aged man with special emphasis on its differential diagnosis.
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Affiliation(s)
- Cheshta Walia
- Department of Oral and Maxillofacial Pathology, Buraydah Private Dental College, Buraydah 31717, Saudi Arabia
| | - Rudra Prasad Chatterjee
- Department of Oral and Maxillofacial Pathology, Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, India
| | - Sanchita Kundu
- Department of Oral and Maxillofacial Pathology, Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, India
| | - Sudip Roy
- Department of Orthodontics, Buraydah Private Dental College, Buraydah 31717, Saudi Arabia
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16
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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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17
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Agrawal J, Kumar YP, Damera DA, Kumar S. Clear cell carcinoma of minor salivary gland: A case of clinical dilemma. Contemp Clin Dent 2014; 5:389-92. [PMID: 25191080 PMCID: PMC4147820 DOI: 10.4103/0976-237x.137965] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Clear cell tumor in oral cavity constitutes an assorted group of lesions, which may be odontogenic, metastatic or of salivary gland origin. Those associated with salivary glands accounts for less than 1% of total cases mainly seen in the major salivary gland. Occurrence of clear cell carcinoma in minor salivary gland is rare and uncommon. Hence, this case of intraoral clear cell carcinoma associated with minor salivary gland of palate in a 57-year-old male patient is being reported.
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Affiliation(s)
- Jayshree Agrawal
- Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Rushikonda, Visakhapatnam, Andhra Pradesh, India
| | - Y Pavan Kumar
- Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Rushikonda, Visakhapatnam, Andhra Pradesh, India
| | - D Ajit Damera
- Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Rushikonda, Visakhapatnam, Andhra Pradesh, India
| | - Suresh Kumar
- Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Rushikonda, Visakhapatnam, Andhra Pradesh, India
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18
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Tan SH, Yeo JF, Kheem Pang BN, Petersson F. An intraosseous sclerosing odontogenic tumor predominantly composed of epithelial cells: relation to (so-called) sclerosing odontogenic carcinoma and epithelial-rich central odontogenic fibroma. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e119-25. [PMID: 24767700 DOI: 10.1016/j.oooo.2014.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/10/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
Abstract
We report a case of an asymptomatic sclerosing odontogenic tumor in a 31-year-old woman. Radiologically, the tumor was well circumscribed, was predominantly radiolucent, and had a peripheral sclerotic margin. Histopathologically, the tumor showed small clusters, strands, and cords of small to medium-sized epithelial tumor cells in a sclerotic collagenous stroma. Immunohistochemically, the tumor cells were positive for broad-spectrum cytokeratins (CKs) (CK7, CK5/6, CK19, and CAM 5.2) and p63. Membranous staining for E-cadherin was present. There was weak to moderate nuclear expression of p16 in 30% of cells. Rare tumor cells were positive for p53. Progesterone receptors were expressed in about 60% of the tumor cells. The proliferative activity (Ki-67) was approximately 2%. A molecular genetic (fluorescence in situ hybridization) study showed no EWSR1 (EWS RNA-binding protein 1) gene rearrangement. No recurrence or metastatic events have been documented at 1-year follow-up. This tumor represents a classification dilemma mainly between epithelial-rich central odontogenic fibroma and the so-called sclerosing odontogenic carcinoma.
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Affiliation(s)
- Sze Hwa Tan
- Registrar, Department of Pathology, National University Health System, Singapore
| | - Jin Fei Yeo
- Associate Professor, Senior Consultant, Department of Oral and Maxillofacial Surgery, National University Health System, Singapore
| | | | - Fredrik Petersson
- Associate Professor, Senior Consultant, Department of Pathology, National University Health System, Singapore.
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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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20
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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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21
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Internal morphology of ameloblastomas: a study of 24 resected specimens. ACTA ACUST UNITED AC 2009; 108:754-62. [DOI: 10.1016/j.tripleo.2009.06.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2008] [Revised: 06/23/2009] [Accepted: 06/26/2009] [Indexed: 11/20/2022]
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22
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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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23
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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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24
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Chera BS, Villaret DB, Orlando CA, Mendenhall WM. Clear cell odontogenic carcinoma of the maxilla: a case report and literature review. Am J Otolaryngol 2008; 29:284-90. [PMID: 18598842 DOI: 10.1016/j.amjoto.2007.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Accepted: 08/05/2007] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clear cell odontogenic carcinoma (CCOC) is a rare tumor of odontogenic origin. It was first described as a clinicopathological entity in 1985, and since then, several case reports have been published. METHODS We present a patient with CCOC treated at the University of Florida and review the pertinent literature. RESULTS We treated a 52-year-old woman with CCOC of the maxilla. She received a maxillectomy and postoperative radiotherapy (RT). She developed pulmonary metastases 2 years after treatment. She remains alive and asymptomatic 7 years after completing treatment and has not required additional therapy. The literature search yielded 48 other case reports. The median age at presentation was 53 years (mean, 55 years), the female-to-male ratio was 2:1, and the most common site of presentation was the mandible. Three patients presented with submandibular lymphadenopathy. Most patients had a surgical resection (35 patients, 71%); the remainder underwent curettage. Six (12%) patients received postoperative RT. Eighty percent of patients who were initially treated with curettage developed a local recurrence. Local and/or regional recurrences occurred in 34% of patients who underwent surgical resection. Six patients developed distant metastatic disease; the most common site of the metastases was the lung. Seven patients died from or with the disease, and 3 are alive with the disease. CONCLUSIONS Clear cell odontogenic carcinoma is a rare tumor of the mandible and maxilla that has the propensity for local destruction and the potential for lymphatic and hematogenous metastases. We recommend radical excision as the primary treatment and that adjuvant RT be added for those who have close or positive margins as well as those with lymph node metastases.
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Affiliation(s)
- Bhishamjit S Chera
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
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26
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Ebert CS, Dubin MG, Hart CF, Chalian AA, Shockley WW. Clear cell odontogenic carcinoma: a comprehensive analysis of treatment strategies. Head Neck 2005; 27:536-42. [PMID: 15772956 DOI: 10.1002/hed.20181] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Odontogenic neoplasms of predominately clear cells are unusual. They represent a diagnostic dilemma, and as a result, treatment strategies are diverse. Our goal is to present two new cases, summarize reported cases of clear cell odontogenic carcinoma (CCOC), assess potential risk factors for recurrence, and propose definitive surgical and therapeutic strategies. METHODS A literature search and analysis was performed. Regression models were used to predict risk factors for recurrence. RESULTS Forty-three cases of CCOC were reviewed, including two reported here. The overall rate of recurrent disease was 55%. Local recurrence rates were higher for curettage (80%) than for resection alone (43%). Age (p = .20), sex (p = .28), and tumor site (p = .50) did not predict risk for recurrence. CONCLUSIONS CCOC is a potentially aggressive tumor with a tendency for recurrence. Treatment strategies should be directed toward wide surgical resection with confirmation of tumor-free margins. Lymph node dissection and adjuvant radiation therapy should be considered in selected cases.
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Affiliation(s)
- Charles S Ebert
- Department of Otolaryngology-Head and Neck Surgery, CB# 7070, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7070, USA.
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27
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Braunshtein E, Vered M, Taicher S, Buchner A. Clear cell odontogenic carcinoma and clear cell ameloblastoma: a single clinicopathologic entity? A new case and comparative analysis of the literature. J Oral Maxillofac Surg 2003; 61:1004-10. [PMID: 12966474 DOI: 10.1016/s0278-2391(03)00311-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Clear cell odontogenic carcinoma (CCOC) is histologically characterized by solid sheets and nests of clear cells. Clear cell ameloblastoma (CCAM) is histologically characterized by an ameloblastomatous component intermixed with an extensive clear cell component. In all literature reviews, no separation has been made between the clinicopathologic features of CCOC and CCAM. PURPOSE We sought to review and analyze the clinicopathologic and radiologic features and the biologic behavior of CCOC and to compare them with those of CCAM to evaluate the possible separation between the 2 lesions. MATERIALS AND METHODS A MEDLINE search of the English-language literature was carried out for CCOC and CCAM. Cases were classified according to their histologic features. RESULTS A total of 27 cases of CCOC (26 from the literature and 1 new case) and 8 cases of CCAM were found. CCOC patients showed a male-to-female ratio of 1:2.4, with a mean age of 59 years. CCAM patients showed a male-to-female ratio of 1.7:1, with a mean age of 44 years. CCOC and CCAM were predominantly found in the mandible. Both CCOC and CCAM showed a high rate of recurrence (50% and 63%, respectively) and metastases (33% and 25%, respectively). Several patients with CCOC presented with metastases at time of diagnosis, whereas patients with CCAM usually developed metastases only after several recurrences. CONCLUSION Based on the relatively small number of cases in the literature on CCOC and CCAM, it is difficult to confidently separate the 2 lesions. Both lesions should be considered low-grade malignancies and could well represent a clinicopathologic continuum of a single disease entity rather than 2 separate lesions.
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Affiliation(s)
- Efraim Braunshtein
- Department of Oral and Maxillofacial Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel
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August M, Faquin W, Troulis M, Kaban L. Clear cell odontogenic carcinoma: evaluation of reported cases. J Oral Maxillofac Surg 2003; 61:580-6. [PMID: 12730837 DOI: 10.1053/joms.2003.50114] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE We present the cases of 4 patients with clear cell odontogenic carcinoma and a contrasting case of a patient with a calcifying epithelial odontogenic tumor from Massachusetts General Hospital. Differential diagnosis, distinguishing characteristics, and data from 32 cases in the literature are also reported. Because this rare tumor behaves aggressively with both regional and distant spread, a better understanding of its biologic behavior is imperative. PATIENTS AND METHODS The 4 patients with clear cell odontogenic carcinoma were women and had an average age of 65 years (range, 40 to 77 years). Three tumors were in the posterior mandible and 1 was in the maxilla. Three patients complained of pain; bony expansion and tooth mobility were noted in isolated cases. A comparison is made with other reported cases, and factors associated with recurrence and survival are presented. RESULTS All patients were treated with resection, and 1 patient received postoperative radiotherapy. Two patients with positive surgical margins underwent further resection. All patients have been followed an average of 2 years (range, 0.5 to 4 years) and presently have no evident disease. CONCLUSIONS Recognition of this unusual tumor and differentiating it from other clear cell neoplasms is critical in developing an appropriate treatment plan. Management should include wide en bloc resection and long-term follow-up.
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Affiliation(s)
- Meredith August
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine and Harvard Medical School, Boston, MA 02114, USA.
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29
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Mosqueda-Taylor A, Meneses-García A, Ruíz-Godoy Rivera LM, de Lourdes Suárez-Roa M. Clear cell odontogenic carcinoma of the mandible. J Oral Pathol Med 2002; 31:439-41. [PMID: 12165062 DOI: 10.1034/j.1600-0714.2002.00133.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article describes a case of clear cell odontogenic carcinoma (CCOC) in a 55-year-old woman who presented such a tumor extending from the midline of the mandible to the right first molar. The tumor was surgically excised and has not recurred or metastasized 6 months after surgery. To date, only 33 well-documented cases have been reported (including the present case) in the English literature. Twenty-eight (84.8%) have developed in the mandible and five (15.2%) in the maxilla. Eighteen (54.5%) occurred anterior to the first molar. The vast majority have been diagnosed in patients older than 40 years (30/33), and the mean age at diagnosis is 57.4 years (range: 17-89), with a male/female ratio: 1/2. Recurrences have been described in 17 cases (51.5%) and metastasis in 10 (30.3%). Based on its morphologic, histochemical and immunophenotypic features, CCOC should be distinguished from other primary and metastatic clear cell tumors of the oral and maxillofacial regions.
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Affiliation(s)
- Adalberto Mosqueda-Taylor
- Departamento de Atención a la Salud, Universidad Autónoma Metropolitana Xochimilco, Mexico City, Mexico.
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