Sclerosing odontogenic carcinoma – what we know so far

Abstract

Sclerosing odontogenic carcinoma (SOC) was described in 2008 and is

A central maxillary tumor with bland cytology, partly sclerotic stroma, and neural involvement. Sclerosing odontogenic carcinoma or epithelial neurotropism in an odontogenic fibroma?

“…However, in some cases of SOC the stroma was cellular 15 or imitated a benign fibro‐osseous lesion, 8, 18 whilst in COdF it was dense 13, 23 . In the present case, it was both densely collagenized and fibroblastic, with small, round calcification, as has been documented in rare cases of SOC 3, 9 and considered “diagnostic” of COdF by some investigators 12 …”

“…The demonstration of epithelial nests in the perineural or intraneural space of small nerves was strongly suggestive of SOC, as it has been reported in most SOCs, 3, 6, 7, 12, 14, 18, 19 with rare exceptions, 9, 15, 25 but in no case of COdF 13 . In contrast to perineural infiltration in carcinomas that is associated with cytological atypia and aggressive behaviour, 26 in SOC frank atypia was rare, 4, 18 recurrences reported in 2 of 14 cases, 8, 15 and metastases have not been documented 12, 19 .…”

“…The demonstration of epithelial nests in the perineural or intraneural space of small nerves was strongly suggestive of SOC, as it has been reported in most SOCs, 3, 6, 7, 12, 14, 18, 19 with rare exceptions, 9, 15, 25 but in no case of COdF 13 . In contrast to perineural infiltration in carcinomas that is associated with cytological atypia and aggressive behaviour, 26 in SOC frank atypia was rare, 4, 18 recurrences reported in 2 of 14 cases, 8, 15 and metastases have not been documented 12, 19 . Although this behaviour has been compared with that of the cutaneous microcystic adnexal carcinoma, 3 there are also examples of benign jaw tumours that show neural infiltration, such as ameloblastoma, 27 as well as of normal structures that imitate neural infiltration.…”

“…The latter include the juxtaoral organ of Chievitz 28 and neuroepithelial structure found in the lingual and buccal mandibular gingiva 29, 30 ; normal jawbones 31, 32 ; cysts, including a primordial cyst and an odontogenic keratocyst of the mandible, 33 a periapical cyst of the maxilla, 34 and a median nasopalatine duct cyst 35 ; and a buccal maxillary exostosis 35 . In neuroepithelial structures, the epithelium is mostly located beneath the perineurium, but perineural localization is not uncommon, 29, 33, 35, 36 whilst intraneural localization was seen in some cases of SOC, 7, 12, 14 and the present one. Therefore, the microscopical features of neural involvement in SOC share similarities with those of neuroepithelial structures.…”

“…The clinical, radiographical and microscopical features of the central maxillary tumour described herein may be seen both in SOC and COdF, as has been previously noticed. 9 Depression on the palatal gingiva attributed to bone perforation and collapse was seen in one case of SOC 12 and some cases of COdF, 13 whilst neurological signs were absent occasionally in SOC 6,14 and usually in COdF. 13 Presentation as a destructive osteolytic lesion is common in SOC 15 and large COdFs of the maxilla.…”