1
|
Oh KY, Hong SD, Yoon HJ. Tumor immune microenvironment in odontogenic carcinomas: Evaluation of the therapeutic potential of immune checkpoint blockade. J Oral Pathol Med 2024; 53:217-225. [PMID: 38449350 DOI: 10.1111/jop.13525] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/21/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Despite recent advances in the use of immune checkpoint blockade (ICB) across various cancer types, its efficacy in odontogenic carcinomas remains unexplored. This study aims to investigate PD-L1 expression and the tumor immune microenvironment (TIME) in odontogenic carcinomas to determine the therapeutic potential of ICB and the significance of immune markers. METHODS The expressions of PD-L1 and T cell markers (CD3, CD8, and FOXP3) were visualized by immunohistochemistry in 21 tissue samples of odontogenic carcinomas. Tumoral PD-L1 expression and the density and spatial distribution of T cell subsets were evaluated, from which TIME was determined. The associations of the variables with clinicopathological and prognostic factors were statistically analyzed. RESULTS PD-L1 was positively expressed in 52.4% (11/21) of the cases studied. Among tumor types, ameloblastic carcinoma showed significantly higher PD-L1 expression (p = 0.016). TIME based on the intratumoral and stromal T cell distribution was immune-inflamed in 61.9% (13/21) and immune-excluded in 38.1% (8/21), with no immune-desert cases. PD-L1 expression was associated with the densities of all intratumoral T cell subsets (p = 0.03 for CD3, p = 0.03 for CD8, and p = 0.008 for FOXP3) but not with those of stromal T cells. High PD-L1 expression was associated with larger tumor size (p = 0.021), while the intratumoral CD8/CD3 ratio was inversely correlated with tumor size (p = 0.048). CONCLUSION These findings indicate the involvement of adaptive immune resistance in a subset of odontogenic carcinomas and support the therapeutic potential of ICB in patients with these rare malignancies.
Collapse
Affiliation(s)
- Kyu-Young Oh
- Department of Oral Pathology, College of Dentistry, Dankook University, Cheonan, Republic of Korea
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seong-Doo Hong
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hye-Jung Yoon
- Department of Oral Pathology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
2
|
Kim CG, Lee GW, Kim HS, Han SY, Han D, Park HM. Case report: Ghost cell odontogenic carcinoma in a dog: diagnostics and surgical outcome. Front Vet Sci 2023; 10:1267222. [PMID: 37929281 PMCID: PMC10620927 DOI: 10.3389/fvets.2023.1267222] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/18/2023] [Indexed: 11/07/2023] Open
Abstract
A 6 year-old spayed female Poodle presented with a mandibular mass. Radiographic examination revealed osteolysis from the right mandibular canine to the fourth premolar, along with horizontal bone loss and dorsal displacement of the right mandibular first and second premolars. Skull cone beam computed tomography revealed osteolysis at the level of the right mandibular canine and fourth premolar. A destructive bone lesion was observed in the apical area of the right mandibular canine, with mass invasion of the interradicular bone of the right mandibular first molar near the mandibular canal. Consequently, unilateral total mandibulectomy and skin flap surgery were performed. Histopathological examination revealed poorly demarcated and infiltrative neoplastic epithelial cells that formed small islands and trabeculae. Neoplastic cells exhibited the malignant features of cytological atypia and high mitotic activity. Furthermore, the neoplastic epithelial cells frequently showed ghost cell changes and were diagnosed as ghost cell odontogenic carcinoma (GCOC). The dog was followed up for 1 year, during which no severe complications or local recurrence was observed, except for slight mandibular drift, tongue protrusion, and drooling. This case report describes the clinical features, diagnostic imaging, and histologic features of an unreported GCOC in a dog and the favorable outcome following surgical resection.
Collapse
Affiliation(s)
- Chun-Geun Kim
- Dentistry and Oral Surgery Service, Evichi Veterinary Dental Hospital, Seoul, Republic of Korea
| | - Ga-Won Lee
- Department of Companion Animal Industry, College of Health and Welfare, Dongshin University, Naju, Republic of Korea
| | - Hyun Sil Kim
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Seung-Yong Han
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Dawool Han
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Hee-Myung Park
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea
| |
Collapse
|
3
|
Bastos VC, Guimarães LM, Gomes CC, Gomez RS. Adenoid Ameloblastoma vs Dentinogenic Ghost Cell Tumor: Are They Related Entities? Mod Pathol 2023; 36:100132. [PMID: 36924756 DOI: 10.1016/j.modpat.2023.100132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 02/15/2023]
Affiliation(s)
- Victor Coutinho Bastos
- Department of Pathology, Biological Science Institute (ICB), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Letícia Martins Guimarães
- Department of Pathology, Biological Science Institute (ICB), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Carolina Cavaliéri Gomes
- Department of Pathology, Biological Science Institute (ICB), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil; Medical School, Faculdade Ciências Médicas de Minas Gerais, Brazil.
| |
Collapse
|
4
|
Abstract
Ameloblastic Carcinoma is a rare malignant Odontogenic tumour with characteristic histopathology and clinical features which requires aggressive surgical treatment and surveillance and therefore differs from ameloblastoma. It is possible that ameloblastoma shows a variety of histologic and biologic behaviour ranging from benign to frank malignancy. Cases of ameloblastoma should thus be studied carefully, correlating their histologic pattern with biologic behaviour to direct subtle changes in histology that may predict the aggressiveness of the tumor. Thus the identifying features of Ameloblastic Carcinoma must be carefully known and recognized by dental professionals. The purpose of this article is to report a rare case of Ameloblastic Carcinoma and to highlight the clinical, radiological and variable histological features with possible differential diagnosis.
Collapse
Affiliation(s)
- T Smitha
- Department of Oral and Maxillofacial Pathology, V.S Dental College and Research Centre, Bengaluru, Karnataka, India
| | - N S Priya
- Department of Oral and Maxillofacial Pathology, V.S Dental College and Research Centre, Bengaluru, Karnataka, India
| | - K N Hema
- Department of Oral and Maxillofacial Pathology, V.S Dental College and Research Centre, Bengaluru, Karnataka, India
| | - R Franklin
- Department of Oral and Maxillofacial Pathology, V.S Dental College and Research Centre, Bengaluru, Karnataka, India
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
7
|
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.
Collapse
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,
| | | |
Collapse
|
8
|
Kallianpur S, Jadwani S, Misra B, Sudheendra US. Ameloblastic carcinoma of the mandible: Report of a case and review. J Oral Maxillofac Pathol 2014; 18:S96-S102. [PMID: 25364189 PMCID: PMC4211248 DOI: 10.4103/0973-029x.141336] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 02/09/2011] [Accepted: 06/02/2014] [Indexed: 11/13/2022] Open
Abstract
Ameloblastic carcinoma is a rare malignant odontogenic neoplasm that can arise either as a de novo lesion or from pre-existing ameloblastoma. Histopathologically, the tumor retains an ameloblastomatous differentiation pattern but shows cytological features of malignancy. Owing to variable biologic behavior and paucity of long-term follow-up cases, there has been no clear consensus on treatment protocol. The present case of ameloblastic carcinoma arose in the mandible of a 24-year-old male. Surgical treatment involved resection of the mandible along with regional lymph nodes. The patient has been on follow up for the past one year without any recurrence or metastases. An update on ameloblastic carcinoma encompassing the histogenesis, immunohistochemical features and treatment aspects are included.
Collapse
Affiliation(s)
- Shreenivas Kallianpur
- Department of Oral and Maxillofacial Pathology, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Sanjay Jadwani
- Department of Oral and Maxillofacial Surgery, Government Dental College and Research Centre, Raipur, Chhattisgarh, India
| | - Biswajit Misra
- Department of Oral and Maxillofacial Surgery, Government Dental College and Research Centre, Raipur, Chhattisgarh, India
| | - U S Sudheendra
- Department of Oral and Maxillofacial Pathology, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| |
Collapse
|
9
|
Kar IB, Subramanyam RV, Mishra N, Singh AK. Ameloblastic carcinoma: A clinicopathologic dilemma - Report of two cases with total review of literature from 1984 to 2012. Ann Maxillofac Surg 2014; 4:70-7. [PMID: 24987603 PMCID: PMC4073467 DOI: 10.4103/2231-0746.133070] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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] [Indexed: 11/17/2022] Open
Abstract
Ameloblastic carcinoma (AC) is a rare primary odontogenic tumor that has histological features of both ameloblastoma and carcinoma. A total number of 92 case reports speak about its rare incidence, affecting mostly the mandible as a locally destructive lesion. The maxilla is affected even more rarely as only 35 cases have been reported until 2012 in scientific literature. The clinical course of AC is generally aggressive, with extensive local bone destruction. The most common clinical features include swelling, pain, trismus, significant bone resorption with tooth mobility, dysphonia and intraoral fistula. We report two cases of AC with aggressive behavior.
Collapse
Affiliation(s)
- Indu Bhusan Kar
- Departments of Oral and Maxillofacial Surgery, S. C. B. Dental College and Hospital, Cuttack, Odisha, India
| | - R V Subramanyam
- Department of Oral and Maxillofacial Pathology, Drs. Sudha and Nageswar Rao Siddhartha Institute of Dental Sciences, Chinoutpalli, Gannavaram, Andhra Pradesh, India
| | - Niranjan Mishra
- Departments of Oral and Maxillofacial Surgery, S. C. B. Dental College and Hospital, Cuttack, Odisha, India
| | - Akhilesh Kumar Singh
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| |
Collapse
|
10
|
Kamath VV, Satelur K, Yerlagudda K. Spindle cell variant of ameloblastic carcinoma arising from an unicystic amelobastoma: Report of a rare case. Dent Res J (Isfahan) 2012; 9:328-33. [PMID: 23087740 PMCID: PMC3469901] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Malignant transformation of ameloblastomas arising from an odontogenic cyst or de novo is well-recognized. Malignancies in ameloblastomas may involve metastasis or a local dysplastic change in the tissue. The latter are classified as ameloblastic carcinomas. A 75-year-old male presented with a mandibular cystic swelling, with no evidence of metastasis. Dysplastic ameloblastic cells with spindle-cell transformation were seen arising from a cystic lining with features of a unicystic ameloblastoma. Immunohistochemically the lesion stained positive with cytokeratin 8,19 and alpha smooth muscle actin, but was negative for vimentin. A diagnosis of spindle-cell ameloblastic carcinoma was made. Spindle-cell ameloblastic carcinomas are rare and this is the second case arising from a unicystic ameloblastoma reported in literature. The recognition of this transformation and inclusion of this entity in the classification of ameloblastic carcinomas is stressed.
Collapse
Affiliation(s)
- Venkatesh V. Kamath
- Department of Oral and Maxillofacial Pathology, Dr. Syamala Reddy Dental College, Hospital and Research Center, Munnekolala, Marathalli, Bangalore, India,Address for correspondence: Dr V V Kamath, Department of Oral and Maxillofacial Pathology, Dr Syamala Reddy Dental College, Hospital and Research Center, Munnekolala, Marathalli, Bangalore-560037, India. E-mail:
| | - Krishnanand Satelur
- Department of Oral and Maxillofacial Pathology, Dr. Syamala Reddy Dental College, Hospital and Research Center, Munnekolala, Marathalli, Bangalore, India
| | - Komali Yerlagudda
- Department of Oral and Maxillofacial Pathology, Dr. Syamala Reddy Dental College, Hospital and Research Center, Munnekolala, Marathalli, Bangalore, India
| |
Collapse
|