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Noda Y, Ohe C, Ishida M, Okano K, Sando K, Hada N, Ebisu Y, Fujisawa T, Yagi M, Iwai H, Tsuta K. Useful diagnostic histogenetic features of ectopic odontogenic ghost cell tumours. BMC Oral Health 2022; 22:134. [PMID: 35443664 PMCID: PMC9022270 DOI: 10.1186/s12903-022-02169-3] [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: 11/21/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ectopic odontogenic tumours are rare and difficult to diagnose. Consequently, they are occasionally misdiagnosed as other tumours and overtreated. Dentinogenic ghost cell tumours (DGCTs) are odontogenic neoplasms characterised by a CTNNB1 mutation, ghost cell appearance, and dentinoid-like calcification. Herein, we present a case of ectopic DGCT on the floor of a patient's mouth, providing reliable clinicopathological and genetic evidence of its odontogenicity for the first time. CASE PRESENTATION A 72-year-old man presented with painless sublingual swelling. Imaging revealed a multi-lobulated, solid-cystic mass on the floor of his mouth. Cytological evaluation showed folded epithelial clusters composed of basaloid cells, keratinised material, and calcification. Histological analysis revealed a multi-cystic, cribriform to solid nest, with an odontogenic satellate reticulum-like epithelium, including ghost cells and dentinoid matrix deposition. Immunohistochemical analysis found that CK19, CK5/6, bcl-2, and p63 were diffuse positive, β-catenin was focal positive in the nuclei, and the cells in the dentinoid matrix were positive for DMP1. The CTNTTB1 mutation was detected, leading to the final diagnosis of ectopic DGCT. There was no recurrence during the 6-month follow-up. CONCLUSIONS Overall, we have presented a comprehensive clinical overview of DGCT and identified its pathological and genetic features. This report will aid in the recognition of this rare disease in the future and help to avoid misdiagnosis and overtreatment.
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Affiliation(s)
- Yuri Noda
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
| | - Chisato Ohe
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Mitsuaki Ishida
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Kimiaki Okano
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Kaori Sando
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Naoya Hada
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Yusuke Ebisu
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Takuo Fujisawa
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Masao Yagi
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Hiroshi Iwai
- Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Koji Tsuta
- Department of Pathology and Laboratory Medicine, Kansai Medical University Hirakata Hospital, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
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Ghita I, Nagai MY, Lubek JE, Stashek KM, Basile JR, Price JB, Papadimitriou JC, Dyalram D, Younis RH. Ghost Cell Odontogenic Carcinoma Arising in a Previous Calcifying Odontogenic Cyst: A Case Report and Review of Literature. Head Neck Pathol 2022; 16:828-835. [PMID: 35389163 PMCID: PMC9424368 DOI: 10.1007/s12105-022-01445-6] [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: 01/27/2022] [Accepted: 03/05/2022] [Indexed: 11/26/2022]
Abstract
Ghost cell odontogenic carcinoma (GCOC) is a rare malignant tumor of odontogenic origin, with only about 50 cases reported in the English literature so far. Histologically, it is characterized by ghost cells, dentinoid deposits, high grade malignant cellular features, and areas of necrosis and invasion. Having common histological features with other odontogenic ghost cell lesions (OGCL) like calcifying odontogenic cyst (COC) and dentinogenic ghost cell tumors, it is crucial to recognize GCOC malignant features, as it can be destructive and invasive, sometimes showing distant metastases and high recurrence rate. For this reason, it may entail more aggressive surgical approach and multimodal therapeutic regimen. Here we present a case report of GCOC arising in a previous COC, treated with surgical excision that showed persistence and recurrence after two years. The clinical and histological features of this rare occurrence are presented, in addition to the surgical approach, and a summary of literature review of OGCL.
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Affiliation(s)
- Ioana Ghita
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD, 21201, USA.
| | - Michael Y Nagai
- Department of Plastic and Reconstructive Surgery, Erie County Medical Center, Buffalo, NY, 14215, USA
| | - Joshua E Lubek
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Maryland, Baltimore, MD, 21201, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, 21201, USA
| | - Kristen M Stashek
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - John R Basile
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD, 21201, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, 21201, USA
| | - Jeffery B Price
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD, 21201, USA
| | - John C Papadimitriou
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, 21201, USA
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Donita Dyalram
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Maryland, Baltimore, MD, 21201, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, 21201, USA
| | - Rania H Younis
- Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, MD, 21201, USA
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, 21201, USA
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