Misdiagnosis of ameloblastoma in a patient with clear cell. Clear cell calcifying epithelial odontogenic tumor e164 23 cases of ceot as a diagnostic challenge due their high content of clear cells. Clear cell odontogenic carcinoma ccoc is a rare intraosseous carcinoma of the jaw. Ccoc is a rare neoplasm with only few cases reported in the literature. Clear cell odontogenic carcinoma ccoc is often considered as a rare tumor, first described by hansen in 1985. This neoplasm was initially thought to be devoid of malignant potential and classified as benign. Pdf clear cell odontogenic carcinoma ccoc researchgate. These results suggest that odontogenic clear cell neoplasms are at least lowgrade malignancies and should be classi. Mandibular clear cell odontogenic carcinoma world journal. Odontogenic tumor composed predominantly of clear cells is a rare neoplasm of the jaws that was initially designated as clear cell odontogenic tumor.
Adenomatoid odontogenic tumor odontogenic tumors are both benign and malignant and have been classified accordingly by who in 1992 which was further divided into sub divisions by white dk in 2004. In this article, we report a challenging example of clear cell variant of calcifying epithelial odontogenic tumor of the posterior maxilla in a 45yearold female patient showing locally. The tumor was surgically excised and has not recurred or metastasized 6 months after surgery. Studies of odontogenic tumors reveal that there are often no clear divisions among many types of tumors, but rather a transition from one to another, and it is not unusual for. A 45 year old woman presented with a radiolucent left mandibular swelling associated with loss of teeth.
Clear cell odontogenic carcinoma ccoc is a rare tumor of odontogenic origin. Cytomorphology and immunohistochemistry of a recurrent clear. In 1992, who classified ccoc as benign odontogenic tumor however, in the who classification of 2005 it was considered to be a malignant tumor of odontogenic origin due to its aggressive nature, predilection to local recurrence, locoregional lymph node. It is a potentially aggressive tumour, capable of recurring frequently, locally invasive, and with distant metastases.
Originally thought of as benign tumors, these neoplasms have been referred to as clear cell odontogenic tumors or clear cell ameloblastomas. In addition to hyalinizing clear cell carcinoma of the salivary gland, it is one of the epithelial neoplasms known to harbor an ewsr1atf1 fusion. A clear cell variant of calcifying epithelial odontogenic tumor is a rare benign odontogenic neoplasm, accounting for 33 cases described in the literature. This article describes a case of clear cell odontogenic carcinoma ccoc in a 55. Clear cell odontogenic carcinoma was first described by hansen et al. Calcifying epithelial odontogenic tumor of the maxilla.
Clear cell variant of calcifying epithelial odontogenic. 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. One cell population was composed of clear cell having clear to faintly eosinophilic cytoplasm b. Due to its infrequency, diagnostic criteria, protocols, and prognosis of ccoc are not often not fully understood. Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring in the anterior region of the mandible in 5th7th decades and shows a female preponderance. In 1992, ccoc was classified as odontogenic tumor by the who 2. A rare case of an aggressive clear cell variant of.
This is an open access article distributed under the creative commons attribution license which permits unrestricted use, distribution, and reproduction in any medium, provided the. Clear cell odontogenic carcinoma ccoc, clear cell odontogenic tumor previously called clear cell ameloblastoma considered benign by who of 1992, but due to its high potential for regional spread and distant metastases, it was reclassified as malignant in 2005. It is potentially aggressive and capable of multiple local recurrences and locoregional and distant metastases. The world health organization has classified clear cell odontogenic tumor among benign tumors, but it is now recognized as a more sinister lesion, and current opinion is that it should be designated as a carcinoma. Calcifying epithelial odontogenic tumor ceot is a rare, benign, locally aggressive odontogenic epithelial tumor that affects the jaws. Sep 24, 2015 ccoc was initially known as clear cell odontogenic tumor or clear cell ameloblastoma. Clear cell odontogenic carcinoma ccoc is described as an exceptional and hard to diagnose malignant tumor which was first. A 45 year old woman presented with a radiolucent left mandibular swelling associated with.
Ccoc was classified as a malignant neoplasm of odontogenic origin by the who in 2005 as it exhibits an aggressive growth pattern, local recurrence, and tendency of distant metastasis. May 24, 20 we present an uncommon case female patient aged 59 years of the clear cell variant of calcifying epithelial odontogenic tumor ceot also known as pindborg tumor in the mandible. Clear cell odontogenic carcinoma ccoc is a rare malignant odontogenic tumor histologically characterized by sheets and lobules of vacuolated and clear cells. Although there are numerous reports on the variants of ceot, occurrence of clear cells with complete absence of calcification has been a rarity. Clear cell odontogenic carcinoma is composed of irregular sheets of neoplastic epithelial cells immersed in a richly cellular, collagenous stroma. Ccoc was initially known as clear cell odontogenic tumor or clear cell ameloblastoma. Ghost cell odontogenic carcinoma is an extremely rare odontogenic tumor with unclear etiology. Clear cell odontogenic carcinoma ccoc, which has been described within the past 2 decades, is a rare odontogenic tumor that tends to occur in the mandible of older adults, with a predilection. The clear cell odontogenic tumor is classified as a benign but locally invasive odontogenic tumor in the current world health organization classification for odontogenic tumors. Clear cell odontogenic carcinoma is a rare jaw lesion with predominantly clear cell characteristics.
To date, only 107 cases have been reported in literature since its first description by hansen et al. Odontogenic tumors of oral cavity linkedin slideshare. Biphasic variant of clear cell odontogenic carcinoma a. Originally thought of as benign tumors, these neoplasms have been re ferred. Genetic profile of clear cell odontogenic carcinoma.
Odontogenic neoplasms composed of predominantly clear cells are quite unusual and represent a diagnostic challenge. Clear cell odontogenic carcinoma ccoc is a rare, lowgrade malignant epithelial neoplasm, occurring in the jawbones, mainly affecting the mandible of elderly patients. Therefore, a link between these tumors seems plausible. In the head and neck region, clear cell tumors are usually derived from salivary glands, odontogenic tissues, and metastasis. Considered benign by who of 1992, but due to its high potential for regional spread and distant metastases, it was reclassified as malignant in 2005. Chapter 21 odontogenic and non odontogenic tumors of the jaws introduction. This tumor is generally considered to be of a low grade of malignancy. Clear cell odontogenic tumor is a rare neoplasm of the jaws that histologically may be confused with metastatic renal cell carcinoma. Clearcell variant of calcifying epithelial odontogenic tumor.
Clear cell odontogenic carcinoma mimicking a cystic lesion. In other words, odontogenic tumors arise from odontogenic tissues. Clear cell odontogenic carcinoma ccoc is a rare odontogenic malignancy with a female predilection, typically presenting as swelling in anterior region of mandible. Clear cell odontogenic carcinoma ccoc is a rare tumor of the head and neck region, first described by hansen et al. Clear cell odontogenic carcinoma ccoc is an infrequent tumor, which is aggressive by nature among the odontogenic tumors. Clear cell variant of calcifying epithelial odontogenic tumor. It is potentially aggressive, capable of frequent recurrences and locoregional and distant metastases.
Mandibular clear cell odontogenic carcinoma springerlink. Formerly known as clear cell odontogenic tumor, a locally aggressive benign tumor in the who classification of 1992, it was renamed ccoc and classified among malignant tumors after the revision of this classification in 2005. Clear cell odontogenic carcinomaa rare case report. Subsequently, similar cases showing aggressive behavior, recurrent behavior and metastatic spread were reported and then designated as clear. Sep 24, 2015 clear cell odontogenic carcinoma ccoc is a rare intraosseous carcinoma of the jaw. Since then, the predominance of the clear cell component in ceots has been reported mainly through single cases and its prognostic importance is still debatable 18. Odontogenic and nonodontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance. Histochemical analysis of tumor cells revealed glycogen granules with pas staining, with. Clear cell odontogenic carcinoma ccoc is a rare odontogenic malignancy with a female predilection, typically presenting as swelling in.
Chapter 21 odontogenic and nonodontogenic tumors of the jaws introduction. A 70yearold woman presented with a large painful radiolucent mandibular lesion from the right canine to the left angle area through the midline. Clear cell odontogenic carcinoma ccoc, which has been described within the past 2 decades, is a rare odontogenic tumor that tends to occur in the mandible of older adults, with a predilection for women. Who classification benign odontogenic epithelium without odontogenic ectomesenchyme ameloblastoma squamous odontogenic tumor pindborgs tumor clear cell odontogenic tumor odontogenic epithelium with odontogenic ectomesenchyme with or without dental hard tissue formation. Clear cell odontogenic carcinoma american journal of. In 1992, who classified ccoc as benign odontogenic tumor however, in the who classification of 2005 it was considered to be a malignant tumor of odontogenic origin due to its aggressive nature, predilection to local recurrence, locoregional. Clear cell lesions in the head and neck region have a wide range of differential diagnosis that includes odontogenic tumors such as ameloblastoma, calcifying epithelial odontogenic tumor, odontogenic carcinoma and salivary gland tumors like. The term clear cell odontogenic tumor was coined by hansen et al. Jul 25, 2018 clear cell odontogenic carcinoma ccoc is a rare, lowgrade malignant epithelial neoplasm, occurring in the jawbones, mainly affecting the mandible of elderly patients. Report of a case and immunohistochemical investigation. Clear cell odontogenic tumor a new histologic variant with aggressive potential. Clear cell odontogenic carcinomaa rare case report europe. Clear cell lesions in the head and neck region have a wide range of differential diagnosis that includes odontogenic tumors such as ameloblastoma, calcifying epithelial odontogenic tumor, odontogenic carcinoma and salivary gland tumors like mucoepidermoid.
Clear cell variant of extraosseous calcifying epithelial odontogenic tumor. Clear cell odontogenic carcinoma ccoc is a rare odontogenic tumor with predominance in the posterior mandible, usually occurring in the fifth to seventh decades of life, and being found more commonly in females. Clear cell odontogenic carcinoma ccoc is a rare odontogenic tumor of the jaws, histologically characterized by the presence of. Mandibular clear cell odontogenic carcinoma europe pmc. Clearcell variant of calcifying epithelial odontogenic. Although touted as a benign lesion in the initial stages, once the aggressive nature of the lesion became evident, it was reclassified as a malignant tumor by the world health. Odontogenic tumor composed predominantly of clear cells is a rare neoplasm of the jaws that was initially. We present an uncommon case female patient aged 59 years of the clearcell variant of calcifying epithelial odontogenic tumor ceot also known as pindborg tumor in the mandible. Clear cell odontogenic carcinoma wiley online library. Clear cell odontogenic carcinoma ccoc is a rare intraosseous carcinoma of the jaw described in 1985 for the first time by hansen 1. Cytomorphology and immunohistochemistry of a recurrent. Subsequent reports in the literature, however, all have indicated that this tumor exhibits an aggressive behavior characterized by infiltrative local growth, recurrence, or metastases.
Clear cell odontogenic carcinoma report of two cases and. They represent a diagnostic dilemma, and as a result, treatment strategies are. Clear cell odontogenic carcinoma tends to be an aggressive tumor with a destructive growth pattern. Clear cell odontogenic carcinoma ccoc is described as an exceptional and hard to diagnose malignant tumor which was first reported by hansen in 1985. Peripheral clear cell variant of calcifying epithelial odontogenic tumor. Who classification benign odontogenic epithelium without odontogenic ectomesenchyme ameloblastoma squamous odontogenic tumor pindborgs tumor clear cell odontogenic tumor odontogenic epithelium with odontogenic ectomesenchyme with or. Clear cell odontogenic carcinoma archives of pathology.
The tumor cells were arranged in the form of islands and chords demonstrating a biphasic cell pattern a. Clear cell odontogenic carcinoma of the mandible, journal. Although known by many names, the basic histologic identifying feature includes the identification of the ghost cells and the malignant changes associated with the cells. Clear cell odontogenic carcinoma ccoc is a rare intraosseous carcinoma of the jaw which was first described as a clear cell odontogenic tumor in 1985 by hansen 1. Clear cell odontogenic carcinoma ccoc, clear cell odontogenic tumor. Benign odontogenic tumors are divided into three types based on the presence absense of odontogenic epithelium or ectomesenchyme. Maxillary clear cell odontogenic carcinoma a rare entity. Clear cell odontogenic carcinoma of the mandible mosqueda. Clear cell odontogenic carcinoma is a rare and unusual tumor that occurs in the jaws. Odontogenic cysts that can be problematic because of recurrence andor aggressive growth include odontogenic keratocyst okc, calcifying odontogenic cyst, and the recently described glandular.
Clear cell odontogenic carcinoma is a rare entity that tends to arise from the body of the mandible during the fifth through seventh decades and has a female preponderance. Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring predominantly in posterior mandible during 5th7th decades with a female predilection. Background clear cell odontogenic carcinoma ccoc, which has been described within the past 2 decades, is a rare odontogenic tumor that tends to occur in the mandible of older adults, with a predilection for women. Ghost cell odontogenic carcinoma arising in the background of a benign calcifying cystic odontogenic tumor of the mandible. Malignant odontogenic tumours histopathology reporting. Odontogenic cysts, odontogenic tumors, fibroosseous, and. Pdf odontogenic neoplasms of predominantly clear cells are unusual. The tumor cells were large, with clear cytoplasm, and arranged in irregular sheets. The clear cell odontogenic tumor is classified as a benign but locally invasive odontogenic tumor in the current world. 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. The other cell population is composed of basaloid cells with minimal amount of.
Histopathological examination revealed a poorly circumscribed tumor of odontogenic epithelium. Primary clear cell carcinoma of minor salivary gland of. Clear cell odontogenic tumor a new histologic variant. Vander poorten vl, balm aj, hilgers fj, tan ib, keus rb, hart aa. Biphasic variant of clear cell odontogenic carcinoma a case. Odontogenic and non odontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance. It was first described as a clinicopathological entity in 1985, and since then, several case reports have been published.
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