Dentinogenic ghost cell tumor: A case report

Abstract

BACKGROUND Dentinogenic ghost cell tumor (DGCT) is an uncommon locally invasive odontogenic neoplasm. It is considered to be a solid variant of calcifying odontogenic cyst (COC). This tumor makes up for only 2%-14% of all COCs and less than 0.5% of all odontogenic tumors which owes to its rarity. The purpose of this paper was to describe a case of DGCT and the treatment adopted in our case, and to provide a review of this case in the indexed literature. CASE SUMMARY In this article, we discussed a case of 18 year old male who reported with a chief complaint of a recurrent swelling and dull aching pain in upper left back region of the jaw. Computed tomography scan was carried out which revealed hypodense lesion with a few hyperdense flecks within it suggesting the presence of calcification. On incisional biopsy, diagnosis of COC was given. After segmental resection of the lesion, histopathogically odontogenic epithelium was noted along with calcifications, ghost cells and dentinoid material. Special staining was done with van Gieson and it showed pink areas of dentinoid material and yellow colour represented ghost cells. Hence, amalgamation of careful clinical examination, use of advanced radiographic imaging and detailed histopathological examination confirmed the diagnosis of DGCT. The patient was followed up for one year and there was no recurrence of the lesion or signs of any residual tumor. CONCLUSION Radical treatment should be carried out along with mandatory long-term follow up in order to avoid recurrence in aggressive lesions.

Variations in Aggressive and Indolent Behaviour of Central Dentinogenic Ghost Cell Tumor

“…The second case showed a classical unilocular well-defined radiolucent lesion with radiopacities in specks. The presentation was in unison with the cases of Patankar et al [ 5 ], Bafna et al [ 8 ], and Garcia et al [ 9 ].…”

“…The result culminated in 1992 with WHO naming the entity as neoplastic, irrespective of its cystic nature. In 2006, dentinogenic ghost cell tumor (DGCT) was the name given to solid variants as suggested by Praetorius et al [ 1 , 2 , 5 ].…”

“…Radiologically, DGCT appears as a unilocular or multilocular radiolucent and radiopaque lesion which is well demarcated [ 5 , 9 , 10 ]. The first case showed a large multilocular radiolucent lesion, partially well defined with radiopacity, an impacted canine, and a well-defined radiopaque mass in the mesial vicinity.…”

“…It can behave subtly, or actively as an aggressive tumor with high recurrence [ 1 , 10 , 11 ]. This calls for an aggressive line of treatment selection and free margins [ 5 ].…”

“…Praetorius et al gave further clarity to the dualistic nature by classifying COC into tumor/solid and cystic lesions with further subclassification as simple, associated with odontome, and associated with ameloblastic proliferation [ 3 ]. The World Health Organization (WHO) in its 2005 classification grouped the solid variants separately which led to the emergence of terms calcifying cystic odontogenic tumor (CCOT) and dentinogenic ghost cell tumor (DGCT) representing the cystic and solid neoplastic type, respectively [ 2 , 4 , 5 ]. The recent WHO classification (2017) of odontogenic tumors retains the term DGCT for the solid variant [ 6 , 7 ].…”