Atypical Presentation of Clear Cell Odontogenic Carcinoma

Abstract

Clear cell odontogenic carcinoma (CCOC) is a rare malignant neoplasm of odontogenic origin. The usual clinical presentation of CCOC is a mass of progressive growth in the mandible sometimes accompanied with loss of teeth, pain, or bleeding. We describe a rare case of CCOC that showed an atypical presentation not previously described in the literature like a fast-growing painless mass in the retromolar area that reached a considerable size in a few days that caused obstruction of the airway. The presence of airway obstruction required immediate treatment, which consisted of a surgical excision of the tumor via a hemimandibulectomy. This clinical report highlights the possibility of odontogenic tumors presenting like a rapid-growing mass and the importance of clinical differential diagnosis of such presentation.

Clear cell odontogenic carcinoma: report of 7 new cases and systematic review of the current knowledge

“…[27][28][29]38,55 In general, a protocol similar to that used for oral squamous cell carcinoma has been used. 4,11,13,46,49,53,54 RxT or ChT do not appear to be useful for long-term disease control when used alone. 39,52 In our review, the patients who received adjuvant or palliative therapies had a lower median survival, which could be explained partially by the advanced stage of their disease and the ineffectiveness of such therapies for CCOC.…”

“…27,47,50,55 A few reports have evaluated PCNA and/or Ki-67 expression in CCOC, with low proliferative activity (less than 8%) shown in these tumors. 27,40,47,51,54 Increased anaplasia has been reported in cases of recurrence, but proliferative activity has not been investigated. In our sample, a higher number of Ki67epositive cells (mean of 35.2 cells/HPF) has been noted as compared with AMEs.…”

“…4,13,14,29,33,44,46,47,55,59 In addition, lymph node dissection has been recommended in cases with positive nodes and/or extracapsular spread. 4,11,13,46,49,[53][54][55] Special attention should be given to level I lymph nodes, the most common nodal site for lymphatic metastasis. 4,11,13,46,49,[53][54][55] Postoperative adjuvant RxT has been reported in cases with cortical erosion, soft tissue or perineural invasion, and in those in which tumor-free margins cannot be determined.…”

“…4,11,13,46,49,[53][54][55] Special attention should be given to level I lymph nodes, the most common nodal site for lymphatic metastasis. 4,11,13,46,49,[53][54][55] Postoperative adjuvant RxT has been reported in cases with cortical erosion, soft tissue or perineural invasion, and in those in which tumor-free margins cannot be determined. [27][28][29]38,55 In general, a protocol similar to that used for oral squamous cell carcinoma has been used.…”

Management of Clear Cell Odontogenic Carcinoma: A Case Report

“…Adjuvant radiotherapy at carcinoma doses of 66 Gy at 2 Gy per fraction delivered once a day or a total dose of 74 Gy at 1.2 Gy per fraction delivered twice daily is advocated by some authors. Chemotherapy is usually reserved for palliative care as there is lack of evidence for its efficacy in definitive treatment [9]. CCOC is a rare odontogenic tumor and very few cases have been reported in the literature.…”