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

Abstract

Aim: This study aimed at evaluating histological features of 52 cases of calcifying odontogenic cyst (COC), which is an uncommon benign odontogenic lesion. The World Health Organization (WHO) classified COC as a neoplasm and used the term calcifying cystic odontogenic tumor (CCOT) for benign cystic type and the dentinogenic ghost cell tumor (DGCT) for the benign solid-type lesions. There is no agreement regarding COC classification. Materials and methods:A total of 52 cases of COC were selected and reviewed from the archive of the Pathology Department of Taleghani Educational Hospital, Tehran, Iran. To better understand the pathogenesis of COC, the cases were classified.Results: There were 52 cases (31 males and 21 females). The lesion was found in all age groups, and patients' age from 8 to 61 years. Nineteen cases affected the maxilla, and 33 cases affected the mandible. Except two cases, all were intraosseous lesions. Radiographically, 30 cases showed a unilocular radiolucent area, and 22 cases showed a mixed radiolucent/ radiopaque region. Histopathologically, 43 cases were cystic type and 9 cases were neoplastic. Conclusion:There are two different histopathological entities. In view of these findings, it is very difficult to determine every lesion that has a cystic architecture is truly cystic or is a neoplastic one in nature. It is believed that the solid variants may be neoplastic.Clinical significance: A better understanding of the histological type of the lesion can provide a classification across patients. This can help in treatment planning to improve patient outcomes.

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

“…In the present survey, the mean age of individuals with COC, DGCT, and GCOC was 30.7, 47.0, and 42.6 years, respectively, in agreement with findings of large case series reported elsewhere . Corroborating data of Ledesma‐Montes et al, Irani & Foroughi, Cheng et al, and Etemad‐Moghadam et al, men seem to be more affected.…”

“…Root resorption or root displacement and cortical erosion could be observed. Root displacement or root resorption may also be absent . DGCT cases were found to have a well‐defined (66.7%) unilocular border (51.8%) with mixed appearance (60.6%).…”

A multicentre study of 268 cases of calcifying odontogenic cysts and a literature review

“…Although some previous reports have not shown a gender preference of COC (Gomes da Silva et al., ; Lucchese et al., ; Shamaskin et al., ), others have demonstrated a male prevalence (Irani & Foroughi, ; Ledesma‐Montes et al., ). In our multicentre study, there was a slight female prevalence (female‐to‐male ratio: 1.2:1), diverging from the present literature review that showed 247 males (56.2%) among the 439 informed cases (male‐to‐female ratio: 1.2:1).…”

“…In this Brazilian survey, COC represented 0.1% of cases among the entire sample of diagnosed oral and maxillofacial lesions and 1.3% of cases among all odontogenic cysts. Two single‐centre studies from Iran (Habibi, Saghravanian, Salehinejad, & Jafarzadeh, ; Irani & Foroughi, ) and an international collaborative study involving 14 institutions of Europe, Africa and America (Ledesma‐Montes et al., ) also provided a large case series of this lesion. The strength of our study regards the report of the frequency of COC identified across 10 reference services in a multicentre collaboration.…”

“…Some epidemiological studies with a larger number of COC cases have been published in the English literature (Irani & Foroughi, ; Ledesma‐Montes et al., ), providing the data necessary to know and determine the clinical, radiographic and histopathological profile of the COC in the different geographic regions of the world. However, reports of case series of COC in South America are uncommon (Fregnani et al., ; Gomes da Silva, Ribeiro Bartholomeu Dos Santos, Cabral, Azevedo, & Pires, ).…”