J Korean Assoc Oral Maxillofac Surg.  2017 Dec;43(6):415-422. 10.5125/jkaoms.2017.43.6.415.

Ghost cell odontogenic carcinoma on right mandible and its respective surgical reconstruction: a case report

• Park SY
• Park J
• Kwon DH
• Jeon JH
• Kim SM
• Myoung H
• Lee JH

• KMID: 2398997
• DOI: http://doi.org/10.5125/jkaoms.2017.43.6.415

Abstract

Calcifying cystic odontogenic tumor (CCOT) is defined as an odontogenic cyst-like benign neoplasm that characteristically contains several ghost cells, ameloblastoma-like epithelium, and occasional calcification. Ghost cell odontogenic carcinoma (GCOC), a malignant form of CCOT, is an exceptionally rare malignant tumor. In this report, we present a case of a 53-year-old man whose chief complaint was a solitary mass on the right mandible area. The mass was completely removed through an extraoral surgical approach and reconstructive surgery was performed in two phases.

Keyword

Ghost cell odontogenic carcinoma; Calcifying odontogenic cyst; Latissimus dorsi myocutaneous free flap

MeSH Terms

Epithelium
Humans
Mandible*
Middle Aged
Odontogenic Cyst, Calcifying
Odontogenic Tumors

Figure

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  Fig. 1 Preoperative extraoral clinical photo.

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  Fig. 2 Preoperative intraoral clinical photo.

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  Fig. 3 Clinical and radiologic findings. A. Panoramic view. B. Preoperative three-dimensional computed tomography (CT) view. C. Preoperative enhanced CT view (axial cut). D. Preoperative enhanced CT view (coronal cut). E. Preoperative positron emission tomography-CT.

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  Fig. 4 A. Post mass resection. B. Main mass.

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  Fig. 5 Radiographic findings after first surgery. A. Panoramic view after first surgery. B. Enhanced computed tomography (CT) view (axial view) after first surgery. C. Enhanced CT view (coronal view) after first surgery.

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  Fig. 6 Main mass.

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  Fig. 7 Histologic findings. A. Malignant epithelial cells with ghost cells (arrows; H&E staining, ×200). B. Atypical cells with prominent pleomorphism (arrows; H&E staining, ×400). C. Long odontogenic epithelial strands with focal clear cell clusters (H&E staining, ×100). D. Dysplastic dentin with concentric calcifications (arrows; H&E staining, ×200). E. Focal necrosis (arrows; H&E staining, ×100).

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  Fig. 8 Histologic findings. A. Immunohistochemical staining (Ki-67). B. Immunohistochemical staining (pan-cytokeratin).

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  Fig. 9 Second reconstruction surgery. A. Previous flap removal. B. Flap harvesting. C. Flap setting.

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  Fig. 10 Six month postoperative follow-up. A. Extraoral clinical photo. B. Intraoral clinical photo.

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