A central maxillary tumor with bland cytology, partly sclerotic stroma, and neural involvement. Sclerosing odontogenic carcinoma or epithelial neurotropism in an odontogenic fibroma?

Abstract

Aim To present a maxillary tumour showing features of sclerosing odontogenic carcinoma (SOC), i.e. bland cytology, partly sclerotic stroma and neural involvement, and contemplate whether its diagnostic feature, neural involvement, could represent epithelial neurotropism in a central odontogenic fibroma (COdF). Materials and methods A 58‐year‐old male presented with a depression on the palatal side of the alveolar ridge, extending from the right canine to the right first molar tooth. A CBCT of the maxilla revealed a multilocular radiolucency, with ill‐defined borders, causing destruction of the buccal and palatal cortical bone. Results Complete removal of the tumour was performed under general anaesthesia. Healing was uneventful and there was no evidence of recurrence in the 36 months clinical and radiographical follow up. The final diagnosis was an odontogenic tumour with bland cytology, sclerosis and neural involvement, consistent with SOC. Conclusions The tumour presented herein showed clinical, radiographical and microscopical features consistent with SOC and COdF, with neural involvement favouring a diagnosis of SOC. Epithelial neurotropism in a COdF could account for the similarities between those lesions and the rather quiescent, for an infiltrative intraosseous carcinoma, clinical behaviour of SOC.