An unusual presentation of ghost cell odontogenic carcinoma: A case report with review of literature

Abstract

Ghost cell odontogenic carcinoma (GCOC) is a malignant odontogenic epithelial tumor which is an exceedingly rare, highly aggressive, rapidly growing, and infiltrative tumor forming the malignant counterpart of long-standing benign cystic lesions coming in the spectrum of calcifying odontogenic cysts. To date, only a few cases have been reported in the medical literature. A case of unusual presentation of GCOC is presented and the clinical, histopathological, and immunohistochemical features are discussed along with a literature review. Our case report further emphasizes the bizarre biological behavior of this tumor and the need for strict long-term surveillance of the patients as metastasis to distant sites has been reported.

Ghost cell odontogenic carcinoma of the jaws: Report of two cases and a literature review

“…Mitoses are frequently observed. Immunohistochemical staining with a panel of antibodies demonstrated that neoplastic cells were strongly positive for cytokeratin and negative for vimentin, desmin, SMA, and CD34[43]. The expression of Ki-67 and MMP-9 may be associated with the proliferation, invasion, and prognosis of GCOC[33].…”

Ghost cell odontogenic carcinoma of anterior mandible: A rare case report with review of literature

“…This appears to be more common in Asian population with a male predilection (male:female ratio of 3.4:1). [ 4 47 ] The age of occurrence is variable from 10 to 89 but with a peak incidence in the fourth decade of life (mean age-43.4 years). GCOC occurs more frequently in the maxilla than the mandible with a usual presentation of a painful swelling with local paresthesias.…”

“…GCOC can appear as either “ de novo ” or as malignant transformation of a preexisting COC, CCOT, DGCT or other odontogenic tumors. [ 2 4 47 ] A careful patient history and clinical data is mandatory to ensure the origin of GCOC. In literature 28 cases found to be de novo in origin whereas 15 cases had previous history of ghost cell lesion spectrum COC, CCOT or DGCT.…”

“…This guideline is followed for the diagnosis of GCOC as well as to rule out its histological differential diagnosis DGCT [ Table 3 ]. [ 4 8 ] The histological features mainly include groups of ghost cells, necrosis, prominent mitoses, infiltrative growth pattern and aggressive behavior. [ 8 ] The accurate diagnosis of GCOC requires extensive sampling of the specimen as the features of malignancy can be focal and the other areas may show benign histology.…”

“…It constitutes about 0.37% to 2.1% of all odontogenic tumors. [ 3 4 ] Entities such as CCOT and DGCT manifest similar clinical and radiological criteria as that of GCOC making the diagnosis challenging. In literature till date only few cases of GCOT have been reported.…”