Microcystic Calcifying Epithelial Odontogenic Tumor

Abstract

Microcystic variant of calcifying epithelial odontogenic tumor is rare. We herein describe an additional well-documented case of microcystic CEOT. The affected patient is a Guatemalan 42-year-old female with an expansile well-defined mixed radiolucent-radiopaque lesion located in the right posterior mandible. The lesion was associated to an unerupted third molar. Histopathologic examination revealed nests and cords of moderately pleomorphic, eosinophilic polyhedral epithelial cells surrounded by a fibromyxoid stroma. The neoplastic cells showed microcystic pattern made of pseudo-glandular spaces with variable diameter. Occasional amyloid deposits and calcified acellular material were observed. Tumor cells were positive for AE1/AE3, CK14, CK19, p63, CD138, and beta-catenin. Conservative surgical resection was performed with an uneventful immediate post-surgical follow-up. After 1 year follow-up there is no evidence of recurrence. Pathologists should be aware of this unusual microcystic presentation of CEOT, which may pose a diagnostic challenge and potential diagnostic dilemma.

A Rare Case of an Aggressive Clear Cell Variant of Calcifying Epithelial Odontogenic Tumor in the Posterior Maxilla

“…7 CEOT may be found either isolated or combined, including different criteria for epithelial cytology and histomorphology, comprising polyhedral epithelial cells with abundant eosinophilic cytoplasm, calcifications, and irregular homogeneous masses of lightly eosinophilic material that stains positively for amyloid. 2,8 In addition, some histologic variants have been described, including CEOT with Langerhans cells, 9 the non-calcifying Langerhans cell-rich CEOT, 10 CEOT with cementumlike and bone-like material, 11 CEOT with myoepithelial cells, 12 CEOT with microcysts, 13 and the clear cell variant of calcifying epithelial odontogenic tumor (CCCEOT). [14][15][16] Moreover, tumors have been documented as hybrid lesions with other odontogenic neoplasms, particularly the adenomatoid odontogenic tumor (AOT).…”

Calcifying epithelial odontogenic tumours: Collaborative study of 32 cases and review of literature

“…It is a rare lesion of the jaws and, to the best of our knowledge, less than 400 cases have been described in the literature (Chrcanovic & Gomez, ). CEOT displays a variety of architectural patterns, and three variants have been described: the Langerhans cell CEOT, the clear‐cell variant and the microcyst variant (Abrams & Howell, ; Afrogheh, Schneider, Mohamed, & Hille, ; Asano et al., ; Hicks, Flaitz, Wong, McDaniel, & Cagle, ; Sánchez‐Romero, Carlos, de Almeida, & Romañach, ; Takata et al., ). A few cases of locally aggressive CEOTs invading adjacent structures (Mohtasham, Habibi, Jafarzadeh, & Amirchaghmaghi, ) and less than 10 cases of malignant transformation of CEOT have been reported in the literature so far (Chrcanovic & Gomez, ).…”

Hybrid odontogenic tumor masquerading as a salivary gland lesion: A diagnostic predicament

“…Various morphological features are reported in CEOT which includes peripheral variants, multifocal presentation, clear cell differentiation, presence of Langerhans cells, calcified material, rare malignant variant, and recently microcystic variant which may mimic metastatic adenocarcinoma or other odontogenic tumors. [ 7 8 9 ] Ductal, cribriform and rosette pattern seen in the present case also created a diagnostic perplexity to rule out salivary gland lesion especially adenoid cystic carcinoma (AdCC). However, absence of increased mitoses, presence of abundant pink cytoplasm, prominent intercellular bridges, amyloid like material and calcifications and low Ki-67 proliferative index ruled out AdCC.…”