Clear cell odontogenic tumor— a new histologic variant with aggressive potential

Abstract

This report delineates the clinical and laboratory findings for a previously unreported neoplasm of putative odontogenic origin. We describe the clinical, radiographic, operative, histologic, histochemical, and ultrastructural findings of the tumor in three women. All lesions were centrally located in the jaw bones, were expansile, and, except for mobile teeth and/or jaw enlargement, exhibited few symptoms. Radiographically, there was bone and tooth destruction resulting in poorly delineated margins. Microscopically, the tumors were nearly identical in that they consisted primarily of large sheets and islands of uniform vacuolated and clear cells without evidence of amyloid deposition, calcification, or glandular differentiation. One of the lesions recurred 1 1/2 years after removal without evidence of metastasis. The results, based only on these cases, suggest that this is a locally aggressive neoplasm of odontogenic origin. Casual microscopic examination of this rare neoplasm could result in misdiagnosis as a metastatic clear cell neoplasm, especially renal cell carcinoma.

Calcifying Epithelial Odontogenic Tumour with Clear Langerhans Cells: A Novel Variant, Report of a Case and Review of the Literature

“…However, there are only a few reported cases of CCEOT with recurrence, and it appears that recurrent CEOTs with clear cell change result from inadequate surgical treatment (curettage and partial resection) [7]. We fully agree with Anavi et al [8], in that Hick's notion of CCEOT's aggressive behaviour emanated from the earlier reports of clear cell odontogenic tumour [27], which is now recognized as a low grade malignancy and classified as CCOC.…”

Malignant Odontogenic Tumors: An Update on Selected Tumors

“…Currently there are approximately 74 reported cases in the English literature [18,19]. Hansen originally described it in 1985 as a benign but aggressive lesion, centrally located in the jaws, under the guise of clear cell odontogenic tumor [20]. Subsequent case reports and small series included additional clinical follow-up that documented the capacity of this neoplasm for local destructive growth with invasion of medullary bone, nerves, lymphatics, as well as regional lymph node and distant metastases (pulmonary, bone) [21][22][23].…”

Calcifying Epithelial Odontogenic Tumor (Ceot)

“…In its ability to recur if treatment is not adequate, the CEOT is similar to the solid/ multicystic ameloblastoma, and although its growth pattern may be slower, some believe that the two should be treated with an identical approach. As reported by Waldron 36 and Hansen 37 , the occurrence of clear cells may prove to be sign of increased tumor aggressiveness indicating the need for more radical surgical approach.…”