A recurring Mandibular Ghost Cell Odontogenic Carcinoma: A Case Report and Review of Literature

Abstract

Background: Ghost cell odontogenic carcinoma (GCOC) is an extremely rare odontogenic carcinoma that is typically characterized by admixture of atypical epithelial cells and ghost cells. Up to date, GCOC remains rare with around 50 cases have been reported. Herein we report a recurrent case of GCOC. Case presentation: A 41-year-old male was suffering from a recurrent fleshy intra-oral swelling in the right mandible associated with pain, paresthesia and facial asymmetry. By history taking, the patient reported that he was subjected to two surgeries to remove tumors that arose in the same place twice previously, knowing that he was diagnosed in the first as adenomatoid odontogenic tumor (AOT) and in the second as calcifying epithelial odontogenic tumor (CEOT). After thorough investigations the patient underwent another surgery with right hemi-mandibulectomy. Histopathological evaluation of the specimen showed atypical epithelial cells, hyperchromatic and pleomorphic ameloblast-like epithelial strands, ghost cells and dentin-like material, indicating the diagnosis of GCOC. Conclusions: GCOC is a rare but aggressive malignant tumor that has a diversity of histological features that may be misinterpreted with other benign calcifying odontogenic cysts and tumors. So, careful diagnosis and wide surgical resection with safety margins are mandatory to minimize its recurrence.