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Sakamoto S, Ando T, Mizuta K, Ono S, Konishi M, Miyauchi M, Ogawa I. Ghost cell odontogenic carcinoma arising in dentinogenic ghost cell tumor, peripheral: A case report. Pathol Int 2023; 73:367-372. [PMID: 37401869 DOI: 10.1111/pin.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/10/2023] [Indexed: 07/05/2023]
Abstract
Ghost cell odontogenic carcinoma (GCOC) is an extremely rare intraosseous malignant odontogenic tumor with prominent ghost cell keratinization and dentinoid formation. Here, we present the first case of GCOC arising in dentinogenic ghost cell tumor (DGCT), peripheral. The patient was a man in his 60s with an exophytic mass in the anterior part of lower gingiva. The resected tumor measured 4.5 cm in maximum diameter. Histologically, the nonencapsulated tumor proliferated in the gingiva without bone invasion. It was predominantly composed of ameloblastoma-like nests and islands of basaloid cells with ghost cells and dentinoid in the mature connective tissue, suggesting DGCT, peripheral. As minor components, sheets of atypical basaloid cells and ameloblastic carcinoma-like nests with pleomorphism and high proliferative activity (Ki-67 labeling index up to 40%) consistent with malignancy were identified. CTNNB1 mutation and β-catenin nuclear translocation were observed in both benign and malignant components. Final diagnosis was GCOC arising in DGCT, peripheral. GCOC shows similar histological features to DGCT. In this unique case without invasion, the cytological atypia and high proliferative activity supports the diagnosis of malignant transformation from DGCT.
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Affiliation(s)
- Shinnichi Sakamoto
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
- Department of Diagnostic & Therapeutic Sciences, Division of Pathology, Meikai University School of Dentistry, Sakado, Japan
| | - Toshinori Ando
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - Kuniko Mizuta
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shigehiro Ono
- Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Mutsumi Miyauchi
- Department of Oral and Maxillofacial Pathobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ikuko Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
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2
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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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3
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Babbitt SG, Bell CM, Raleigh M, Haggerty K, Feigin K. Cystic Odontogenic Tumor with Features of Calcifying Odontogenic Cyst in 3 Cats and a Dog. J Vet Dent 2022; 39:194-202. [PMID: 35410530 DOI: 10.1177/08987564221089403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This case series describes the clinical appearance, radiographic appearance and histopathologic features of 4 patients (3 cats and 1 dog) with unique cystic oral lesions that are consistent with a diagnosis of calcifying odontogenic cyst (COC). COC is a rare odontogenic lesion in humans that has not been previously reported in companion animals. Historically, COC in humans has been classified as a benign cystic neoplasm and as a non-neoplastic odontogenic cyst. Current classification favors the latter. The cases in this series also have ambiguous features regarding classification of the lesion as an odontogenic cyst versus benign neoplasia.
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Affiliation(s)
- Samuel G Babbitt
- Virginia Veterinary Center, 3312 West Cary St., Richmond, Virginia 23221, USA
| | - Cynthia M Bell
- Specialty Oral Pathology for Animals, 637 N State St., Geneseo, IL 61254, USA
| | - Matthew Raleigh
- Animal Dentistry and Oral Surgery, 165 Fort Evans Rd., Leesburg, VA 20176, USA
| | - Kevin Haggerty
- 415428Red Bank Veterinary Hospital, 197 Hance Ave., Tinton Falls, NJ 07724, USA
| | - Kristina Feigin
- Veterinary Dental Services, 530 Massachusetts Ave., Boxborough, MA 01719, USA
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4
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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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5
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Garg A, Malhotra R, Urs AB. Ghost cells unveiled: A comprehensive review. J Oral Biosci 2022; 64:202-209. [PMID: 35398253 DOI: 10.1016/j.job.2022.03.005] [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: 11/23/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Ghost cells (GCs) are cells with distinct intracytoplasmic keratinization, which leads to the preservation of the cellular outline with a clear area corresponding to the previous nucleus location. GCs may show various patterns, such as degeneration, tissue granulation, and calcification. Their true nature and the mechanism regulating the conversion of odontogenic epithelial cells into GCs remain unclear. GC keratinization is different from normal keratinization as they are larger than keratotic squames, are frequently vacuolated, and have prominent nuclear membrane remnants. Few cystic lesions, odontogenic tumors, and non-odontogenic tumors, such as calcifying odontogenic cyst, craniopharyngioma, pilomatrixoma, odontoma, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma, exhibit GCs as a typical feature. The Wnt and Notch signaling pathways play a role in the histogenesis of the neoplasms. HIGHLIGHT The review clarifies the various proposed hypotheses of the histogenesis of GCs, including molecular pathogenesis. Diagnostic workup for the identification of GCs, including special staining and immunohistochemistry, has been extensively discussed. A stepwise algorithm for identifying odontogenic and non-odontogenic lesions containing GCs has been proposed. Additionally, the prognostic role of GCs in the lesions has been elucidated. CONCLUSION Among the various hypotheses of the origin of GCs, we suggest that aberrant keratinization is the most accepted based on various immunohistochemical studies and special staining characteristics. GCs are a distinct characteristic entity of many odontogenic and non-odontogenic lesions; however, it remains controversial whether their presence has any pathognomonic role in the biological nature of these lesions.
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Affiliation(s)
- Aarushi Garg
- Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi 110002, India.
| | - Rewa Malhotra
- Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi 110002, India.
| | - Aadithya B Urs
- Head of Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi 110002, India.
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Cabo I, Saura A, Cardoso AR, Cardoso JA. Peripheral dentinogenic ghost cell tumour. BMJ Case Rep 2022; 15:e245513. [PMID: 35039348 PMCID: PMC8768483 DOI: 10.1136/bcr-2021-245513] [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: 11/07/2021] [Indexed: 11/04/2022] Open
Abstract
The dentinogenic ghost cell tumour (DGCT) is a rare benign neoplasm, which histologically presents itself as an aberrant keratinisation of the epithelium, ghost cells and dentinoid material. Depending on its location there are two different types of DGCT, central or peripheral, with different clinical characteristics. By 2019, there were only 57 cases of DGCT published: 39 of the central type and 18 of the peripheral type.In this clinical case, the authors describe the case of a 78-year-old man with a painless and slow growing mandibular lump. The diagnosis of peripheral DGCT was made by incisional biopsy and the treatment consisted of radical excision with upper marginal mandibulectomy.The aim of the article is to report a clinical case of a rare pathology and, consequently, to help diagnose and better understand its biological behaviour.
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Affiliation(s)
- Ivan Cabo
- Department of Stomatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - André Saura
- Department of Stomatology, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Ana Rita Cardoso
- Department of Stomatology and Maxillofacial Surgery, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
| | - José Azenha Cardoso
- Department of Stomatology and Maxillofacial Surgery, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal
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7
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Nel C, Robinson L, Roza ALOC, Vargas PA, Nortjé CJ, van Heerden WF. Calcifying odontogenic cysts: A 20-year retrospective clinical and radiological review. Dentomaxillofac Radiol 2021; 50:20200586. [PMID: 33591801 DOI: 10.1259/dmfr.20200586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Calcifying odontogenic cysts (COCs) exhibit diverse clinical behaviours and may be associated with other benign odontogenic tumours. In this study, the clinical and radiological features of COCs were analysed according to subtypes based on the classification by Praetorius et al. Emphasis was placed on cases exhibiting atypical or aggressive radiological appearances. This information may assist the clinician to better understand the radiological spectrum of COCs. METHODS Histologically confirmed cases of COCs were retrospectively reviewed in a 20-year period from three tertiary institutions. The following clinical information was reviewed: patient demographics, main complaint, clinical duration, anatomical site and detailed radiological features. RESULTS Twenty-seven cases of COCs were included in the study. Asymptomatic swelling was the main clinical presentation with infrequent reports of associated pain. COCs had an anterior mandibular predilection. Well-demarcated borders were seen in all cases with isolated cases showing focal areas with loss of demarcation. Unilocular lesions were more common than multilocular variants. Internal calcifications were frequent and six cases presented with associated odontomas. Maxillary COCs resulted in the displacement of the maxillary sinus and/or nasal cavity walls. Radiological signs of aggression, including cortical destruction, were noted in a few cases. CONCLUSION Given the fact that COCs can present with a spectrum of clinical behaviours and radiological presentations, the academic debate regarding the cystic versus neoplastic nature of the entity is justifiable. The cases in the current sample presented with diverse presentations, ranging from indolent to lesions with significant growth and aggression.
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Affiliation(s)
- Chané Nel
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Pablo Agustin Vargas
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Christoffel Johannes Nortjé
- Department of Diagnostics and Radiology, Faculty of Dentistry, University of the Western Cape, Western Cape, South Africa
| | - Willie Fp van Heerden
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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8
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da Silva Barros CC, de Souto Medeiros MR, de Azevedo RA, da Costa Miguel MC, Dos Santos JN, da Silveira ÉJD. Peripheral dentinogenic ghost cell tumor-report of two cases and review of the literature. Oral Maxillofac Surg 2021; 25:575-579. [PMID: 33586115 DOI: 10.1007/s10006-021-00947-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/21/2021] [Indexed: 12/31/2022]
Abstract
Peripheral dentinogenic ghost cell tumor (DGCT) is a rare and non-aggressive benign odontogenic tumor. They usually affect the elderly and are predominantly located in the anterior region of the jaws. Their differential diagnosis includes reactive/inflammatory gingival lesions. We report here two cases of peripheral DGCT in a 73-year-old female and a 48-year-old male patient and review the cases published in the literature. Both lesions presented as a nodular lesion in the mandible, and panoramic radiography showed no abnormalities. Microscopically, it was observed to be an ameloblastomatous epithelial proliferation associated with clusters of ghost cells and dysplastic dentin. Immunohistochemistry revealed positivity for cytokeratin 19 and a low Ki-67 proliferative index. Based on histopathological features and the absence of radiographic findings, a diagnosis of peripheral DGCT was rendered. The low number of cases published of peripheral DGCT makes case reports important in providing information that helps in their diagnoses and management.
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Affiliation(s)
- Caio César da Silva Barros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | - Maurília Raquel de Souto Medeiros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | | | - Márcia Cristina da Costa Miguel
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil
| | | | - Éricka Janine Dantas da Silveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil.
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9
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A multicentre study of 268 cases of calcifying odontogenic cysts and a literature review. Oral Dis 2018; 24:1282-1293. [DOI: 10.1111/odi.12906] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/10/2018] [Accepted: 05/27/2018] [Indexed: 11/26/2022]
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10
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de Arruda JAA, Monteiro JLGC, Abreu LG, de Oliveira Silva LV, Schuch LF, de Noronha MS, Callou G, Moreno A, Mesquita RA. Calcifying odontogenic cyst, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma: A systematic review. J Oral Pathol Med 2018; 47:721-730. [PMID: 29738629 DOI: 10.1111/jop.12727] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aim of this study was to integrate the available data published on calcifying odontogenic cyst (COC), dentinogenic ghost cell tumor (DGCT), and ghost cell odontogenic carcinomas (GCOCs) into a comprehensive analysis of their clinicoradiological features, treatment, and recurrence. MATERIALS AND METHODS An electronic search with no publication date restriction was undertaken in October 2017 in the following databases: PubMed, Medline Ovid, Web of Science, and Scopus. Eligibility criteria included publications containing enough clinical, radiological, and histopathological information to confirm a definite diagnosis of these lesions. Data were evaluated descriptively. RESULTS The literature review indicated a total of 234 publications reporting 367 COCs, 55 DGCTs and 44 GCOCs. These lesions have a predilection for Asian males. COCs mainly affect the mandible and patients in the second decade of life, DGCTs mostly affect the mandible and patients in the fourth decade of life, and GCOCs mostly affect the maxilla and patients in the fifth decade of life. CONCLUSION Conservative surgery was the most common therapy for COCs and DGCTs, while radical surgery was most common for GCOCs. This study provides important and interesting data that could help clinicians and surgeons as well as oral and maxillofacial pathologists with the diagnosis and management of these lesions.
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Affiliation(s)
- José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Leni Verônica de Oliveira Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mariana Saturnino de Noronha
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Gerhilde Callou
- Department of Oral and Maxillofacial Surgery and Pathology, School of Dentistry, Universidade de Pernambuco, Camaragibe, PE, Brazil
| | - Amália Moreno
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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11
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Sheikh J, Cohen MD, Ramer N, Payami A. Ghost Cell Tumors. J Oral Maxillofac Surg 2016; 75:750-758. [PMID: 27865804 DOI: 10.1016/j.joms.2016.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/18/2016] [Accepted: 10/18/2016] [Indexed: 11/27/2022]
Abstract
Ghost cell tumors are a family of lesions that range in presentation from cyst to solid neoplasm and in behavior from benign to locally aggressive or metastatic. All are characterized by the presence of ameloblastic epithelium, ghost cells, and calcifications. This report presents the cases of a 14-year-old girl with a calcifying cystic odontogenic tumor (CCOT) and a 65-year-old woman with a peripheral dentinogenic ghost cell tumor (DGCT) with dysplastic changes, a rare locally invasive tumor of odontogenic epithelium. The first patient presented with a 1-year history of slowly progressing pain and swelling at the left body of the mandible. Initial panoramic radiograph displayed a mixed radiolucent and radiopaque lesion. An incisional biopsy yielded a diagnosis of CCOT. Decompression of the mass was completed; after 3 months, it was enucleated and immediately grafted with bone harvested from the anterior iliac crest. The second patient presented with a 3-month history of slowly progressing pain and swelling at the left body of the mandible. Initial panoramic radiograph depicted a mixed radiolucent and radiopaque lesion with saucerization of the buccal mandibular cortex. An incisional biopsy examination suggested a diagnosis of DGCT because of the presence of ghost cells, dentinoid, and islands of ameloblastic epithelium. Excision of the mass with peripheral ostectomy was completed. At 6 and 12 months of follow-up, no evidence of recurrence was noted.
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Affiliation(s)
- Jason Sheikh
- Former Resident, Mount Sinai Medical Center, New York, NY; Fellow, Cleft and Craniomaxillofacial Surgery, Charleston Area Medical Center, Charleston, WV.
| | - Molly D Cohen
- Chief Resident, Department of Oral and Maxillofacial Pathology, Mount Sinai Medical Center, New York, NY
| | - Naomi Ramer
- Director, Oral and Maxillofacial Pathology Residency Program, Mount Sinai Medical Center, New York, NY
| | - Ali Payami
- Attending, Department of Oral and Maxillofacial Surgery, Mount Sinai Medical Center, New York, NY
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12
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Jayasooriya PR, Mendis BRRN, Lombardi T. A Peripheral Dentinogenic Ghost Cell Tumor With Immunohistochemical Investigations and a Literature Review-Based Clinicopathological Comparison Between Peripheral and Central Variants. Int J Surg Pathol 2015; 23:489-94. [PMID: 26162397 DOI: 10.1177/1066896915594881] [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] [Indexed: 12/18/2022]
Abstract
The aim of the study was to present a peripheral dentinogenic ghost cell tumor (DGCT) and to describe clinicopathological differences between peripheral and central variants of the tumor using a selected literature review. The case report is based on a swelling present on the alveolar ridge of a 74-year-old edentulous denture wearer. The lesion was diagnosed as a peripheral DGCT after excluding the presence of a central lesion. Immunohistochemical investigations revealed similar cytokeratin expression pattern, with CK14 and MNF116 positivity in both the tumor and the surrounding surface epithelium. However, in contrast, CK19 expression was restricted to less than 5% of the tumor cells. A clinicopathological comparison was compiled using 30 cases of peripheral DGCTs (including the present lesion) and 16 cases of central DGCTs published over a period of 40 years. Accordingly, peripheral lesions were more often found in elderly denture wearers, in relation to mandibular gingiva and alveolar mucosa. None of the lesions had recurred after excision. In contrast, majority of the central lesions were common in younger individuals and showed a striking male predilection. It occurred equally on both jaws, while approximately 50% of the lesions gave rise to recurrences. In conclusion, similar cytokeratin expression in both the tumor and surface epithelium can be used to support oral surface epithelial origin, while CK14 positivity confirms the odontogenic derivation of the peripheral DGCT described in the report. In contrast to central DGCT, the peripheral DGCT is a distinct lesion with characteristic clinicopathological profile and nonaggressive behavior.
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