Current Concepts and Occurrence of Epithelial Odontogenic Tumors: II. Calcifying Epithelial Odontogenic Tumor Versus Ghost Cell Odontogenic Tumors Derived from Calcifying Odontogenic Cyst

Abstract

Calcifying epithelial odontogenic tumors (CEOTs) and ghost cell odontogenic tumors (GCOTs) are characteristic odontogenic origin epithelial tumors which produce calcifying materials from transformed epithelial tumor cells. CEOT is a benign odontogenic tumor composed of polygonal epithelial tumor cells that show retrogressive calcific changes, amyloid-like deposition, and clear cytoplasm. Differentially, GCOTs are a group of transient tumors characterized by ghost cell presence, which comprise calcifying cystic odontogenic tumor (CCOT), dentinogenic ghost cell tumor (DGCT), and ghost cell odontogenic carcinoma (GCOC), all derived from calcifying odontogenic cysts (COCs). There is considerable confusion about COCs and GCOTs terminology, but these lesions can be classified as COCs or GCOTs, based on their cystic or tumorous natures, respectively. GCOTs include ameloblastomatous tumors derived from dominant odontogenic cysts classified as CCOTs, ghost cell-rich tumors producing dentinoid materials as DGCTs, and the GCOT malignant counterpart, GCOCs. Many authors have reported CEOTs and GCOTs variably express keratins, β-catenin, BCL-2, BSP, RANKL, OPG, Notch1, Jagged1, TGF-β, SMADs, and other proteins. However, these heterogeneous lesions should be differentially diagnosed to allow for accurate tumor progression and prognosis prediction.

The Diagnostic Usefulness of Immunohistochemistry for Odontogenic Lesions

“…The proliferation fraction, as assessed by Ki-67, is very similar to ameloblastoma, particularly in those lesions where the lining is obviously ameloblastoma-like [39,40]. The solid lesions show a similar immunophenotype [41].…”

Calcifying odontogenic cyst, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma: A systematic review

“…Calcifying odontogenic cysts (COC), dentinogenic ghost cell tumors (DGCT), and ghost cell odontogenic carcinomas (GCOCs) represent a group of odontogenic ghost cell lesions (OGCL) of the jaws. The term “ghost cells” in OGCL was introduced in 1946 by Thoma and Goldman, emphasizing the origin and nature of these lesions and portraying their microscopic characteristic …”

“…Retrospective studies, case reports, or case series with a significant number of COC cases have been published in the English scientific literature . In contrast, reports on DGCT and GCOC are scarce .…”

“…4,[14][15][16] Retrospective studies, case reports, or case series with a significant number of COC cases have been published in the English scientific literature. 2,3,5,6,13,15,[17][18][19] In contrast, reports on DGCT and GCOC are scarce. [10][11][12][13][14][15][16][18][19][20] To the best of our knowledge, no systematic review about clinicoradiological appearance and therapy of COC, DGCT, and GCOC has been found in the literature thus far.…”

Histologic Variants of Calcifying Odontogenic Cyst: A Study of 52 Cases

“…other odontogenic tumors. [23][24][25] Ameloblastomatous COC is different from true ameloblastoma arising in COC as despite ameloblastoma ex-COC, the ghost cells and dystrophic calcification can be observed within the proliferative epithelium. The coexistence of COC with odontoma is controversial.…”