1
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Koga S, Gates JC, Peters SM, Cooper K. Intraosseous mandibular clear cell odontogenic carcinoma with predominant small round blue cells: a potential diagnostic pitfall. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00405-X. [PMID: 39155171 DOI: 10.1016/j.oooo.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/19/2024] [Accepted: 07/20/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVE Clear cell odontogenic carcinoma (CCOC) is a rare malignancy of the jaw, presenting significant diagnostic challenges. This report aims to highlight the complexities associated with biopsy-based diagnoses of oral and maxillofacial lesions, as demonstrated in a case of intraosseous mandibular CCOC initially suggestive of Ewing's sarcoma due to its presentation with small round blue cells. RESULTS The patient, a 37-year-old male, presented with a mandibular lesion that on incisional biopsy was suggestive of Ewing's sarcoma. Subsequent, comprehensive histologic evaluation after definitive resection via mandibulectomy revealed a CCOC, characterized by a biphasic pattern of clear and basaloid cells. Histological examination confirmed the presence of glycogen-rich clear cells, supported by periodic acid-Schiff (PAS) staining and confirmed by PAS diastase staining, which demonstrated glycogen digestion. Immunohistochemistry was positive for AE1/AE3, p40, and p63, while negative for c-kit and CD34, confirming CCOC and excluding other malignancies such as Ewing's sarcoma, which would have been treated with neoadjuvant chemotherapy instead of primary surgical treatment as in CCOC. CONCLUSION This case highlights the essential need for thorough histopathological evaluation and the value of a second opinion via additional histologic consultation, particularly due to the diagnostic challenges of heterogeneous lesions in the oral and maxillofacial region.
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Affiliation(s)
- Shunsuke Koga
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
| | - James C Gates
- Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Scott M Peters
- Department of Pathology and Oral Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, Pennsylvania, USA
| | - Kumarasen Cooper
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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2
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Robertson IJ, Robbins QC, Li PC. Case of metastatic clear cell odontogenic carcinoma with response to chemoimmunotherapy. BMJ Case Rep 2024; 17:e259568. [PMID: 38684356 PMCID: PMC11146348 DOI: 10.1136/bcr-2023-259568] [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] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
Our patient initially presented with 6 months of left jaw pain and gingival bleeding, leading to the discovery of a radiolucent left maxillary mass on dental evaluation. A biopsy confirmed clear cell odontogenic carcinoma, and the patient was treated with definitive surgery and radiation for localised disease. Unfortunately, the patient was found to have pulmonary metastases 3 months after initial management and was subsequently treated with a combination of cytotoxic chemotherapy and immunotherapy with a partial response. To our knowledge, this is the first case demonstrating the successful use of chemoimmunotherapy in metastatic clear cell odontogenic carcinoma.
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Affiliation(s)
- Ian J Robertson
- Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Quinn C Robbins
- Oral and Maxillofacial Pathology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Peter C Li
- Hematology/Oncology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
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3
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Xhori O, Deol N, Rivera CM, Zavras J, Weil SG, Zafari H, Thierauf JC, Faquin WC, Choy E, Rivera MN, John Iafrate A, Jaquinet A, Troulis MJ. A Comparison of Clear Cell Sarcoma to Jaw and Salivary Tumors Bearing EWS Fusions. Head Neck Pathol 2024; 18:25. [PMID: 38526767 DOI: 10.1007/s12105-024-01625-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/04/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVE To review tumors identified as "clear cell sarcoma" in order to determine similarities to the rare EWS fusion positive jaw and salivary gland tumors clear cell odontogenic carcinoma (CCOC) and clear cell carcinoma of the salivary gland (CCC). METHODS PubMed was used to collect all reports of clear cell sarcoma (CCS). Search parameters were "clear cell sarcoma" and "CCS." References in the publications were screened and cross-referenced. Data extracted included demographic characteristics, presenting signs and symptoms, radiographic findings, histological and immunohistochemical features and known molecular/genetic aberrations. RESULTS Clear cell sarcoma has several similarities to CCOC and CCC. All three tumor types have similar histologic appearances including the presence of clear cells, as well as similar genetic profiles in that all harbor an EWSR1-CREB family fusions. Additionally, these tumors appear in soft tissue as well as bone, and can have a prolonged clinical course. CCS can appear anywhere in the body, including the head and neck region. All three tumors appear to have a predilection to women, although CCS may have a slight younger age of onset as compared to CCOC and CCC (3rd vs 5th decade of life, respectively). CONCLUSION Gaining a better understanding of the similarities and differences between these three tumors may lead to a better understanding of each one.
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Affiliation(s)
- Ornela Xhori
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, 02113, USA
| | - Navkiran Deol
- Harvard School of Dental Medicine, DMD'25, 188 Longwood Avenue, Boston, MA, 02115, USA.
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, 02113, USA.
| | - Camron M Rivera
- Harvard School of Dental Medicine, DMD'25, 188 Longwood Avenue, Boston, MA, 02115, USA
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, 02113, USA
| | - Jason Zavras
- Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Sophia G Weil
- Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Hirad Zafari
- Harvard School of Dental Medicine, DMD'25, 188 Longwood Avenue, Boston, MA, 02115, USA
| | - Julia C Thierauf
- Department of Pathology, Massachusetts General Hospital, Boston, MA, 02113, USA
| | - William C Faquin
- Department of Pathology, Massachusetts General Hospital, Boston, MA, 02113, USA
- Harvard Medical School, 27 Shattuck Street, Boston, MA, 02115, USA
| | - Edwin Choy
- Harvard Medical School, 27 Shattuck Street, Boston, MA, 02115, USA
- Division of Hematology Oncology, Massachusetts General Hospital, Boston, MA, 02113, USA
| | - Miguel N Rivera
- Department of Pathology, Massachusetts General Hospital, Boston, MA, 02113, USA
- Harvard Medical School, 27 Shattuck Street, Boston, MA, 02115, USA
| | - A John Iafrate
- Department of Pathology, Massachusetts General Hospital, Boston, MA, 02113, USA
- Harvard Medical School, 27 Shattuck Street, Boston, MA, 02115, USA
| | | | - Maria J Troulis
- Harvard School of Dental Medicine, DMD'25, 188 Longwood Avenue, Boston, MA, 02115, USA
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, 02113, USA
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4
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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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5
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Das AK, Khandelwal K. Clear cell Odontogenic Carcinoma Mandible Mimicking oral Cavity Squamous cell Carcinoma: An Intriguing case with Review of Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:1055-1059. [PMID: 37274982 PMCID: PMC10235296 DOI: 10.1007/s12070-022-03354-0] [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: 05/12/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic neoplasm with high risk of recurrence and aggressive behaviour. Presence of clear cells in head and neck is hallmark, but not pathognomic for the entity. Deceptive behaviour admist wide range of differentials, poses an immense diagnostic challenge. An incisional biopsy with appropriate immunohistochemistry is prudent for diagnosis. We herein report atypical case of CCOC mimicking squamous cell carcinoma, in a tertiary cancer center in North Eastern part of India.
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Affiliation(s)
| | - Kirti Khandelwal
- Department of Head and Neck Surgery, Dr. B. Borooah Cancer Institute, Guwahati, India
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6
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Dixit S, Kumar A, Srinivasan K. A Current Review of Machine Learning and Deep Learning Models in Oral Cancer Diagnosis: Recent Technologies, Open Challenges, and Future Research Directions. Diagnostics (Basel) 2023; 13:1353. [PMID: 37046571 PMCID: PMC10093759 DOI: 10.3390/diagnostics13071353] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/25/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023] Open
Abstract
Cancer is a problematic global health issue with an extremely high fatality rate throughout the world. The application of various machine learning techniques that have appeared in the field of cancer diagnosis in recent years has provided meaningful insights into efficient and precise treatment decision-making. Due to rapid advancements in sequencing technologies, the detection of cancer based on gene expression data has improved over the years. Different types of cancer affect different parts of the body in different ways. Cancer that affects the mouth, lip, and upper throat is known as oral cancer, which is the sixth most prevalent form of cancer worldwide. India, Bangladesh, China, the United States, and Pakistan are the top five countries with the highest rates of oral cavity disease and lip cancer. The major causes of oral cancer are excessive use of tobacco and cigarette smoking. Many people's lives can be saved if oral cancer (OC) can be detected early. Early identification and diagnosis could assist doctors in providing better patient care and effective treatment. OC screening may advance with the implementation of artificial intelligence (AI) techniques. AI can provide assistance to the oncology sector by accurately analyzing a large dataset from several imaging modalities. This review deals with the implementation of AI during the early stages of cancer for the proper detection and treatment of OC. Furthermore, performance evaluations of several DL and ML models have been carried out to show that the DL model can overcome the difficult challenges associated with early cancerous lesions in the mouth. For this review, we have followed the rules recommended for the extension of scoping reviews and meta-analyses (PRISMA-ScR). Examining the reference lists for the chosen articles helped us gather more details on the subject. Additionally, we discussed AI's drawbacks and its potential use in research on oral cancer. There are methods for reducing risk factors, such as reducing the use of tobacco and alcohol, as well as immunization against HPV infection to avoid oral cancer, or to lessen the burden of the disease. Additionally, officious methods for preventing oral diseases include training programs for doctors and patients as well as facilitating early diagnosis via screening high-risk populations for the disease.
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Affiliation(s)
- Shriniket Dixit
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore 632014, India
| | - Anant Kumar
- School of Bioscience and Technology, Vellore Institute of Technology, Vellore 632014, India
| | - Kathiravan Srinivasan
- School of Computer Science and Engineering, Vellore Institute of Technology, Vellore 632014, India
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7
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Clear Cell Odontogenic Carcinoma: A Series of Three Cases. Dent J (Basel) 2022; 10:dj10030034. [PMID: 35323236 PMCID: PMC8947699 DOI: 10.3390/dj10030034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/07/2022] [Accepted: 02/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic epithelial neoplasm of the jaws. It is composed of irregular nests of clear to faintly eosinophilic cells resembling clear cell rests of primitive dental lamina and an intermixed hyalinized fibrous stroma. Most cases occur in the 5th and 6th decades of life, with a female predominance. The mandible is affected more than the maxilla. Clinical features vary from asymptomatic to non-specific pain, ill-defined radiolucency, root resorption, and sometimes soft tissue extension. Histology varies from bland to high grade. CCOC demonstrated a significant tendency to recur. Metastasis typically involves regional lymph nodes, which haves been reported in 20–25% of cases. Pulmonary metastasis rarely occurs. Differential diagnoses are broad and include odontogenic, salivary, melanocytic, and metastatic neoplasia. CCOCs are positive for cytokeratins, mainly AE1/AE3 and CK19. Most cases show EWSR1 rearrangement and rarely, the BRAFV600E mutation. Design: Patient charts were reviewed at our institution. A total of three cases were found in electronic medical records, which were diagnosed as clear cell odontogenic carcinoma over a period of six years (2014–2019). Patient charts were reviewed for medical history and radiology data. The pathology slides were reviewed by one or more faculty members. Results: We present three cases of CCOC, ranging in age from 40 to 69 years (two women and one man). Two cases involved the maxilla and one involved the mandible. Two presented with painful swelling and one with mass recurrence. Radiography results show that two had poorly defined radiolucent lesions, and one was heterogeneous with a small nodule projecting into the maxillary sinus. Histological examination revealed an epithelial neoplasm composed of irregular sheets, cords, and nests of polygonal cells with central hyperchromatic, mildly pleomorphic nuclei surrounded by clear to pale eosinophilic cytoplasm, with occasional mitotic figures. The tumor had infiltrated the bone and soft tissues. Two cases were immunopositive for CK5/6 and one case was positive for p63 and CK19. Interestingly, the eosinophilic dentinoid matrix interspersed among tumor cells in one case was consistent with its odontogenic origin. Histochemical staining showed PAS-positive and diastase-labile intracytoplasmic material consistent with glycogen. Conclusion: Our study highlights the potential diagnostic significance of dentinoid (although reportedly seen in only 7% of cases), along with CK5/6 immunopositivity, in supporting the histologic diagnosis of CCOC among a variety of neoplasia in its differential diagnosis.
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8
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Sharma P, Wadhwan V, Singh R. Oral metastatic clear-cell tumours: To and fro: Unusual case reports. J Oral Maxillofac Pathol 2022; 26:268-272. [PMID: 35968179 PMCID: PMC9364646 DOI: 10.4103/jomfp.jomfp_104_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 02/09/2022] [Accepted: 02/26/2022] [Indexed: 11/04/2022] Open
Abstract
We report two extremely rare cases of metastatic clear-cell carcinomas, which metastasized from and to the oral cavity and both presented clinically in the oral cavity. First case was a primary lesion in the oral cavity, which showed distant metastatic deposits in liver, kidney, bone and brain. Histopathologically, lobules of pleomorphic clear cells were evident descending from the overlying mucosa, raising the suspicion of renal cell carcinoma. Immunohistochemical staining for CD10 was negative and the case was diagnosed as clear-cell type of oral squamous cell carcinoma which had disseminated to distant organs. In the second case, dysplastic clear granular cells were seen invading the bone. Immunohistochemical staining for CD10 showed focal mild positivity, confirming the diagnosis as clear-cell renal carcinoma which had metastasized to the oral cavity. Metastatic tumours must be considered in the differential diagnosis of rapidly growing ulcero proliferative lesions in the oral cavity.
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Affiliation(s)
- Preeti Sharma
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India,Address for correspondence: Dr. Preeti Sharma, BH-15, Pallavpuram, Phase – I, Meerut, Uttar Pradesh - 250 110, India. E-mail:
| | - Vijay Wadhwan
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
| | - Roli Singh
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Subharti Dental College, Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
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9
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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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10
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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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11
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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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12
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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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13
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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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14
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Priya NS, Annaji AG, Keerthi R, Umadevi HS. Clear cell odontogenic carcinoma of mandible: An unclarified entity. J Oral Maxillofac Pathol 2018; 22:392-395. [PMID: 30651685 PMCID: PMC6306577 DOI: 10.4103/jomfp.jomfp_117_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Morphological tampering of cellular architecture is a frequent phenomenon, leading to a spectrum of histological melange at light microscopic level. One such group of tumors which exhibit diagnostic and therapeutic dilemmas are the Clear cell tumors. Clear Cell Odontogenic Carcinoma (CCOC) is an infrequent tumor, which is aggressive by nature among the odontogenic tumors. A case of CCOC of mandible in a denture wearer is presented with the emphasis on diagnostic work up and clarified and unclarified facts of the tumor.
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Affiliation(s)
- N S Priya
- Department of Oral Pathology, V S Dental College and Hospital, Bengaluru, Karnataka, India
| | - A G Annaji
- Department of Oral Medicine and Radiology, V S Dental College and Hospital, Bengaluru, Karnataka, India
| | - R Keerthi
- Department of Oral and Maxillofacial Surgery, V S Dental College and Hospital, Bengaluru, Karnataka, India
| | - H S Umadevi
- Department of Oral Pathology, V S Dental College and Hospital, Bengaluru, Karnataka, India
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15
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Clear cell odontogenic carcinoma. A review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:363-370. [DOI: 10.1016/j.jormas.2017.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 06/27/2017] [Accepted: 08/04/2017] [Indexed: 11/21/2022]
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16
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RAHPEYMA A, KHAJEHAHMADI S, HASHEMI EM. Perinöral İnvazyon Gösteren Alt Çene Berrak Hücreli Odontojenik Karsinom: Bir Derleme. CUMHURIYET DENTAL JOURNAL 2017. [DOI: 10.7126/cumudj.307315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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17
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Kujiraoka S, Tsunematsu T, Sato Y, Yoshida M, Ishikawa A, Tohyama R, Tanaka M, Kobayashi Y, Kondo T, Ushio A, Otsuka K, Kurosawa M, Saito M, Yamada A, Arakaki R, Nagai H, Nikai H, Takeuchi K, Nagao T, Miyamoto Y, Ishimaru N, Kudo Y. Establishment and characterization of a clear cell odontogenic carcinoma cell line with EWSR1-ATF1 fusion gene. Oral Oncol 2017; 69:46-55. [PMID: 28559020 DOI: 10.1016/j.oraloncology.2017.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/10/2017] [Accepted: 04/05/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic tumor (MOT) characterized by sheets and lobules of vacuolated and clear cells. To understand the biology of CCOC, we established a new cell line, CCOC-T, with EWSR1-ATF1 fusion gene from a mandible tumor with distant metastasis and characterized this cell line. MATERIALS AND METHODS To detect the EWSR1-ATF1 fusion gene, we used three CCOC cases, including the present case, by RT-PCR and FISH analysis. We characterized established CCOC-T cells by checking cell growth, invasion and the expression of odontogenic factors and bone-related factors. Moreover, the gene expression profile of CCOC-T cells was examined by microarray analysis. RESULTS Histologically, the primary tumor was comprised of cords and nests containing clear and squamoid cells separated by fibrous septa. In addition, ameloblastomatous islands with palisaded peripheral cells were observed, indicating probable odontogenic origin. This tumor expressed the fusion gene EWSR1-ATF1, which underlies the etiology of hyalinizing clear cell carcinoma (HCCC) and potentially that of CCOC. We found a breakpoint in the EWSR1-ATF1 fusion to be the same as that reported in HCCC. Established CCOC-T cells grew extremely slowly, but the cells showed highly invasive activity. Moreover, CCOC-T cells expressed bone-related molecules, odontogenic factors, and epithelial mesenchymal transition (EMT)-related molecules. CONCLUSION To the best of our knowledge, this is the first report on the establishment of a CCOC cell line. CCOC-T cells serve as a useful in vitro model for understanding the pathogenesis and nature of MOT.
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Affiliation(s)
- Satoko Kujiraoka
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Takaaki Tsunematsu
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yukiko Sato
- Department of Pathology, Cancer Institute, Japanese Foundation of Cancer Research, Tokyo, Japan
| | - Maki Yoshida
- Department of Human Pathology, Tokyo Medical University, Tokyo, Japan
| | | | - Rei Tohyama
- Department of Clinical Laboratory, Tokyo Medical and Dental University, Dental Hospital, Tokyo, Japan
| | - Michio Tanaka
- Department of Pathology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Yutaka Kobayashi
- Department of Oral Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Tomoyuki Kondo
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Aya Ushio
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kunihiro Otsuka
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Mie Kurosawa
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masako Saito
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Akiko Yamada
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Rieko Arakaki
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hirokazu Nagai
- Department of Oral Surgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Hiromasa Nikai
- Department of Oral Maxillofacial Pathobiology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Kengo Takeuchi
- Department of Pathology, Cancer Institute, Japanese Foundation of Cancer Research, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Human Pathology, Tokyo Medical University, Tokyo, Japan
| | - Youji Miyamoto
- Department of Oral Surgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Naozumi Ishimaru
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
| | - Yasusei Kudo
- Department of Oral Molecular Pathology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan.
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18
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Devi A, Kamboj M, Singh V, Singh S. Clear-cell variant of squamous cell carcinoma in maxilla as primary lesion: A rare case. J Oral Maxillofac Pathol 2017; 21:425-428. [PMID: 29391719 PMCID: PMC5763867 DOI: 10.4103/jomfp.jomfp_180_16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Oral squamous cell carcinoma with prominent clear-cell differentiation is a rare occurrence with incompletely understood etiology. We report a case of a 55-year-old male working in a steel factory presented with an ulcerated swelling on maxillary alveolar ridge, a rare site. Histopathology showed sheets of squamous cells with clear cell differentiation and features of malignancy. Periodic acid-Schiff and mucicarmine stains showed negative reaction. Immunohistochemical study using antibody for cytokeratin and epithelial membrane antigen revealed diffuse and intense positivity. The neoplastic cells showed complete negative reaction with antibodies for S-100 and vimentin.
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Affiliation(s)
- Anju Devi
- Department of Oral Pathology, Pt. B. D. Sharma University of Health Sciences, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Mala Kamboj
- Department of Oral Pathology, Pt. B. D. Sharma University of Health Sciences, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Virender Singh
- Department of Oral Surgery, Pt. B. D. Sharma University of Health Sciences, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Sunita Singh
- Department of General Pathology, Pt. B. D. Sharma University of Health Sciences, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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19
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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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20
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Kwon IJ, Kim SM, Amponsah EK, Myoung H, Lee JH, Lee SK. Mandibular clear cell odontogenic carcinoma. World J Surg Oncol 2015; 13:284. [PMID: 26404490 PMCID: PMC4582711 DOI: 10.1186/s12957-015-0693-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 09/07/2015] [Indexed: 11/17/2022] Open
Abstract
Background Clear cell odontogenic carcinoma (CCOC) is a rare intraosseous carcinoma of the jaw; only 81 cases have been reported in the English literatures. Case presentation We reported an additional case and reviewed the existing literature. A 70-year-old woman presented with a large painful radiolucent mandibular lesion from the right canine to the left angle area through the midline. No metastatic lymph nodes or distant metastases were detected. She underwent wide surgical resection and reconstruction with a composite fibula free flap. She had no recurrence or metastasis after 18 months. Conclusion CCOC occurs predominantly in women in their 50s–70s in the mandible. Painless swelling is the most common symptom, followed by pain, teeth loosening, and paresthesia. CCOC has a good prognosis after surgery. In large mandibular CCOC, wide resection and composite fibula free flap reconstruction is the treatment of choice.
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Affiliation(s)
- Ik Jae Kwon
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, Korea.
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, Korea. .,Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunayni, Ghana.
| | - Emmanuel Kofi Amponsah
- Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunayni, Ghana
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, Korea.
| | - Jong Ho Lee
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, Korea.
| | - Suk Keun Lee
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea.
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21
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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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22
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Harbhajanka A, Lamzabi I, Jain R, Gattuso P, Kluskens L. Cytomorphology and immunohistochemistry of a recurrent clear cell odontogenic carcinoma with molecular analysis: A case report with review of literature. Diagn Cytopathol 2015; 43:743-6. [PMID: 26061809 DOI: 10.1002/dc.23297] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/27/2015] [Accepted: 04/09/2015] [Indexed: 11/09/2022]
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare, odontogenic tumor of the jaws with mandibular involvement usually present in sixth decade of life with female preponderance. It is classified as a malignant tumor of odontogenic origin in 2005 by the World Health Organization because of its aggressive and destructive growth capacity and potential to metastasize. It needs to be distinguished from other primary and metastatic clear cell tumors of the oral and maxillofacial region. Recently, CCOCs have been noted to harbor a Ewing sarcoma breakpoint region 1 gene RNA-binding protein 1 (EWSR1) and activating transcription factor (ATF) gene translocation. To date, cytologic features of only one case have been reported in the literature. We report an additional case of 55-year-old woman with enlarging mass in the left mandible. This report describes cytologic and immunohistochemical features of CCOC with positive EWSR1 gene rearrangements by fluorescence in situ hybridization (FISH). As diagnosis of CCOC is challenging on fine-needle aspiration, immunohistochemistry and FISH analysis are very useful diagnostic tool in clear cell lesions of mandible.
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Affiliation(s)
- Aparna Harbhajanka
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Ihab Lamzabi
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Richa Jain
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Larry Kluskens
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
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23
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Ginat DT, Villaflor V, Cipriani NA. Oral Cavity Clear Cell Odontogenic Carcinoma. Head Neck Pathol 2015; 10:217-20. [PMID: 25994920 PMCID: PMC4838979 DOI: 10.1007/s12105-015-0635-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 05/12/2015] [Indexed: 11/29/2022]
Abstract
A case of clear cell odontogenic carcinoma of the oral cavity is described in this sine qua non radiology-pathology correlation article. CT demonstrated a solid and cystic mass arising from the mandible. Histology demonstrated variably-sized nests of clear to pale eosinophilic cells with occasional central necrosis embedded in a hyalinized to fibrocellular stroma. The specimen was also positive for the characteristic rearrangement of the EWSR1 (22q12) locus in 93.5% of interphase cells.
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Affiliation(s)
- Daniel Thomas Ginat
- />Department of Radiology, Pritzker School of Medicine, University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637 USA
| | - Victoria Villaflor
- />Department of Medicine, Section of Hematology Oncology, Pritzker School of Medicine, University of Chicago, Chicago, IL USA
| | - Nicole A. Cipriani
- />Department of Pathology, Pritzker School of Medicine, University of Chicago, Chicago, IL USA
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24
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Ganvir SM, Gajbhiye NY. An unusual presentation of clear cell odontogenic carcinoma in mandibular anterior region. J Oral Maxillofac Pathol 2015; 18:442-8. [PMID: 25949004 PMCID: PMC4409194 DOI: 10.4103/0973-029x.151344] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 01/10/2015] [Indexed: 11/16/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare, potentially aggressive odontogenic epithelial tumor with tendency for recurrence. It was first described as a clinicopathological entity in 1985 and to date only 73 cases has been reported in English literature. A case of CCOC in 64-year-old male patient in mandibular anterior region is presented which when recurred in soft tissue 5 years after wide surgical resection of mandible, revealed a biphasic pattern as against monophasic pattern of primary neoplasm and was unusually associated with primary squamous cell carcinoma, suggestive of hybrid tumor.
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Affiliation(s)
- Sindhu M Ganvir
- Department of Oral Pathology, Government Dental College and Hospital Nagpur, Maharashtra, India
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25
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Richardson MS, Muller S. Malignant odontogenic tumors: an update on selected tumors. Head Neck Pathol 2014; 8:411-20. [PMID: 25409848 PMCID: PMC4245406 DOI: 10.1007/s12105-014-0584-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 11/01/2014] [Indexed: 01/10/2023]
Abstract
This is an update on selected odontogenic malignancies. The article deals with aspects of recognized odontogenic carcinomas, odontogenic sarcoma and a yet unrecognized entity, sclerosing odontogenic carcinoma. Odontogenic malignancies are exceedingly rare, complicating a thorough understanding of the biologic behavior, reproducible standardized diagnostic criteria, appropriate classification and clinical management. Without the knowledge of the tumor's biologic behavior, adequate clinical management is difficult and patient outcomes uncertain. The histopathologic features are emphasized as well as the more recent biomarker findings. These recent advances may facilitate further understanding of this group of malignancies and provide useful stratification to guide patient management.
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Affiliation(s)
- Mary S Richardson
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 165 Ashley Ave, EH 303D4, Charleston, SC, 29425, USA,
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26
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Kim M, Cho E, Kim JY, Kim HS, Nam W. Clear cell odontogenic carcinoma mimicking a cystic lesion: a case of misdiagnosis. J Korean Assoc Oral Maxillofac Surg 2014; 40:199-203. [PMID: 25247151 PMCID: PMC4170665 DOI: 10.5125/jkaoms.2014.40.4.199] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 07/10/2014] [Accepted: 07/29/2014] [Indexed: 11/07/2022] Open
Abstract
Clear cell odontogenic carcinoma (CCOC) is a rare jaw tumor that was classified as a malignant tumor of odontogenic origin in 2005 by the World Health Organization because of its aggressive and destructive growth capacity and metastasis to the lungs and lymph nodes. We report a case of a 66-year-old female who had swelling, incision and drainage history and a well-defined unicystic radiolucent lesion that was comparable to a cystic lesion. At first, the patient received decompression, and the lesion size decreased. Three months after decompression, cyst enucleation was performed. The pathologic result indicated that the lesion was CCOC. In this report we emphasize that patients with painful cystic lesions in addition to jaw enlargement and loosening teeth should be considered for the possibility of malignancy.
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Affiliation(s)
- Minkyu Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Eunae Cho
- Department of Oral Pathology, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyun Sil Kim
- Department of Oral Pathology, College of Dentistry, Yonsei University, Seoul, Korea
- Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
- Oral Cancer Research Institute, College of Dentistry, Yonsei University, Seoul, Korea
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