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Rustemeyer J, Busch A, Junker K. Dentinogenic Ghost Cell Tumour in Childhood Involving the Temporomandibular Joint: Considerations and Therapy. J Maxillofac Oral Surg 2024; 23:210-218. [PMID: 38312958 PMCID: PMC10830969 DOI: 10.1007/s12663-023-01874-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
Background Although the uncommon dentinogenic ghost cell tumour (DGCT) is a benign entity, it possesses the ability to cause widespread destruction of the jaws and to recur after bone-preserving therapy. Hence, clear margins should be achieved upon surgery, and reconstruction techniques must often be used to restore osseous defects. However, this can be challenging in cases with involvement of the temporomandibular joint (TMJ), and especially in children. Case report We present a case of a DGCT in a 12-year-old boy with wide infiltration of the mandible and the TMJ. A two-staged reconstructive approach was performed. Upon primary surgery, tumour-free margins were obtained and mandibular anatomy was restored using an iliac crest graft and an alloplastic condyle implant for temporary TMJ reconstruction. In a second step 5 months later, having received a customized TMJ prosthesis consisting of a fossa and a condyle component, the TMJ was completely replaced for definitive reconstruction. Conclusion A customized TMJ prosthesis could be a solution for reconstruction of the TMJ in children. However, the further course with respect to growth disturbances must be evaluated upon short-term follow-ups and might require additional corrective interventions.
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Affiliation(s)
- Jan Rustemeyer
- Department of Oral and Maxillofacial Surgery and Plastic Operations, Klinikum Bremen–Mitte, School of Medicine of the University of Göttingen, Bremen, Germany
| | - Alexander Busch
- Department of Oral and Maxillofacial Surgery and Plastic Operations, Klinikum Bremen–Mitte, School of Medicine of the University of Göttingen, Bremen, Germany
| | - Klaus Junker
- Institute of Pathology, Klinikum Bremen–Mitte, School of Medicine of the University of Göttingen, Bremen, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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