Dentinogenic ghost cell tumor a neoplastic variety of calcifying. In this paper, we present a case of ccot and discuss its distinct histopathologic features in recurrence. In simple terms, odontogenic tumors arise from odontogenic or tooth forming apparatus. Dentinogenic ghost cell tumor cheshta walia, bina kashyap, sudip roy1 departments of oral and maxillofacial pathology and 1orthodontics and dentofacial orthopedics, buraydah private dental college, buraydah, saudi arabia case report introduction the world health organization who panel of experts. A complete workup of a case of peripheral dentinogenic ghost cell tumor is. Central dgct may have a locally invasive behavior with variable rates of recurrence. Dentinogenic ghost cell tumor dgct is a rare tumorous form of calcifying odontogenic cyst and only a small number of cases have been described. The purpose of this study is to assess the diagnosis, treatment and prognosis of the dentinogenic ghost cell tumor dgct. They are locally invasive neoplasms and their main characteristic features are ameloblastoma like odontogenic epithelial proliferation, an aberrant keratinization in the form of ghost cells and dysplastic dentin. Dentinogenic ghost cell tumora rare case report with. These authors preferred the term epithelial odontogenic ghost cell tumor to dentinogenic ghost cell tumor, because the latter connotes a mesenchymal tissue origin and the production of true dentin, whereas. Dentinogenic ghost cell tumor dgct is a rare, odontogenic neoplasm which is considered to be a solid variant of calcifying odontogenic cyst coc with locally aggressive behavior. This report presents a case of peripheral dgct on the left side of the mandibular alveolar ridge of a heavy smoker, a 68yearold man, with main presenting feature as a mild pain. A dentinogenic ghost cell tumor is a locally invasive neoplasm that is characterized by ameloblastoma.
It is an exceedingly rare, highly aggressive, rapidly growing, and infiltrative tumor with increased risk of local recurrence and distant metastasis. The extraosseous odontogenic tumors may raise diagnostic challenges due to their imitation for reactive gingival lesions. Although the condition is often described as being cystic 85% of the cases, a significant percentage of calcifying odontogenic cysts grow as more solid, seemingly neoplastic proliferations, and the term dentinogenic ghost cell tumor has been used to describe these lesions. Dentinogenic ghost cell tumor comprises less than 0. The latest 4th edition of the world health organization classification of head and neck tumours has recently been published with a number of significant changes across all tumour sites.
The dentinogenic ghost cell tumor comes under the spectrum of ghost cell lesions. Chapter 21 odontogenic and nonodontogenic tumors of the jaws introduction. The dentinogenic ghost cell tumor the dentinogenic ghost cell tumor tajima, y ohno, j utsumi, n. Dentinogenic ghost cell tumors dgct are very rare tumors considered as solid variants of calcifying epithelial odontogenic cysts ceoc. The majority of cases have been reported to occur in the anterior part of the jaws. Despite of the rarity of this entity, pdgct should be included in the differential diagnosis of the gingival tumors. Dentinogenic ghost cell tumor first proposed by praetorius in 1981 synonyms. The tumor consisted predominantly of ghost cells with occasional areas of dentinoid in close proximity to masses of ghost cells. Dentinogenic ghost cell tumors dgcts were defined histopathologically in the 2005 world health organization who histological classification of odontogenic tumors as locally invasive neoplasms characterized by ameloblastomalike islands of epithelial cells in a mature connective tissue stroma, aberrant keratinization comprised of ghost cells, and an association with. Peripheral dentinogenic ghost cell tumor kamat ss, diwakar.
To the best of our knowledge, only 88 cases of dgct have been reported in the literature from 1968 to 2014. The case report is based on a swelling present on the alveolar ridge of a 74yearold edentulous denture wearer. Ghost cell odontogenic carcinoma gcoc is a malignant odontogenic epithelial tumor with features of calcifying cystic odontogenic tumor ccot andor dentinogenic ghost cell tumor dgct. Case report mandibular ghost cell odontogenic carcinoma. Dentinogenic ghost cell tumor of the peripheral variant mimicking. A dentinogenic ghost cell tumour dgct is an extremely rare odontogenic tumour which is considered as a solid, neoplastic variant of calcifying odontogenic cyst. The dentinogenic ghostcell tumor dgct, a solid variant of the coc, is an uncommon odontogenic neoplasm occurring predominantly in later life. Mar 25, 2018 ghost cell odontogenic carcinoma gcoc is a rare malignant neoplasm characterized by the presence of ghost cells. Dentinogenic ghost cell tumor a neoplastic variety of calcifying odontogenic cyst. Peripheral dentinogenic ghost cell tumor is a rare tumor with only 24 cases previously described in the english literature. A variant of dentinogenic ghost cell tumor dgct was described by praetorius et al. Current concepts and occurrence of epithelial odontogenic.
Ghost cell odontogenic carcinoma with suspected cholesterol. Predictive factors of potential malignant transformation. Clinicopathologic analysis and syndecan1 and ki67 expression in calcifying cystic odontogenic tumors, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma. It is a locally invasive neoplasm that is characterized by ameloblastomalike epithelial islands, ghost cells and dentinoid. Dentinogenic ghost cell tumor free full text articles from. Distant metastasis of intraosseous dentinogenic ghost cell. At the time of writing 2016, it is still the most widely used classification system although a new revision is due to come up in 2017. Clinical, radiographical and histopathological evaluation 39 the third case was of a 14year old sudanese female who was complaining of a swelling on the left side of the mandible that started several months ago. The dentinogenic ghost cell tumor tajima, y ohno, j utsumi, n. Dentinogenic ghost cell tumors dgct are uncommon lesions mainly with rare peripheral types.
The dentinogenic ghost cell tumor dgct, a solid variant of the coc, is an uncommon odontogenic neoplasm occurring predominantly in later life. Gomes da silva w, ribeiro bartholomeu dos santos tc, cabral mg, et al. Hence, patients should be treated with more radical approach and should be kept on long term. Among them, the peripheral dentinogenic ghost cell tumor pdgct is an extremely rare benign odontogenic neoplasm with up to 30 cases published in the literature. The peripheral variant of this clinical rarity appears as a wellcircumscribed mass mimicking a nonspecific gingival enlargement. Dentinogenic ghost cell tumors journal of oral and maxillofacial. A transition from basaloid to ghost cells is seen in most areas which may be abrupt or gradual. Peripheral dentinogenic ghost cell tumor free full text. Dentinogenic ghost cell tumor dgct is a rare, odontogenic neoplasm which is considered to be a solid variant of calcifying odontogenic cyst coc with locally. Adequate surgical intervention is required for aggressive lesions like dentinogenic ghost cell tumor. The ghost shadow cells in the center of the islands have abundant, pale, eosinophilic cytoplasm with well defined cell borders and central clear area. In 1962, coc was recognized as a distinct clinicopathological entity by gorlin et al. According to who 2005, ghost cell odontogenic carcinoma is a malignant epithelial tumor with features of calcifying cystic odontogenic tumor or dentinogenic ghost cell tumor.
A case occurring in posterior molar region of the mandible in a 75yearold edentulous woman is reported. Dentinogenic ghost cell tumor dgct, also known as odontogenic ghost cell tumor, is considered as a rare neoplastic variant of calcifying odontogenic cyst coc. The dentinogenic ghost cell tumor dgct is a rare benign odontogenic tumor histologically characterized by islands of odontogenic epithelium with the presence of ghost cells and dysplastic dentin at different stages of calcification. Aggressive epithelial odontogenic ghost cell tumor in the. Lekshmy jayan i mds department of oral pathology guided by. Dentinogenic ghost cell tumor a neoplastic variety of. Pdgct occurs in older adults most commonly in the anterior mandibular region. Pyogenic granuloma mimicking peripheral dentinogenic ghost cell tumour recurrence. Peripheral dentinogenic ghost cell tumor, journal of oral. A lesion categorized between ghost cell odontogenic carcinoma. Dentinogenic ghost cell tumor dgct was first described by praetorius et al. Hu qet al the diagnosis and treatment of dentinogenic ghost cell tumor. Odontogenic and nonodontogenic tumors of the jaws are a relatively rare and heterogeneous group of benign and malignant neoplasms, hamartomas, and other bonerelated lesions that demonstrate great variability in etiology, biologic behavior, and clinical significance.
Coc constitute 12% of all odontogenic tumors and 214% of coc are mainly solid tumors 1. Calcifying cystic odontogenic tumor ccot demonstrates considerable diversity in histopathology and clinical behavior. Ghost cell odontogenic carcinoma gcoc is the rare malignant counterpart of ccot and it frequently arises from malignant transformation of a recurrent ccot. Dentinogenic ghost cell tumor dgct is a rare neoplasm, representing 1. A case report author links open overlay panel masanobu yamatoji a mari igarashi a shunsaku ishige b yasuhiro saito c toshihiro shimizu d ayumi yamamoto e atsushi kasamatsu f yosuke endosakamoto f masashi shiiba g hideki tanzawa a f katsuhiro uzawa a f.
Dentinogenic ghost cell tumor dgct is an uncommon locally invasive odontogenic neoplasm. Copy of dentinogenic ghost cell tumor ready dental. Ghost cell odontogenic carcinoma gcoc is a rare malignant neoplasm characterized by the presence of ghost cells. According to who 2005, ghost cell odontogenic carcinoma is a malignant epithelial tumor with features of calcifying cystic odontogenic tumor or dentinogenic ghost cell tumor classified as an odontogenic carcinoma, which includes. Peripheral dentinogenic ghost cell tumor of the gingiva. 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. This is a retrospective study of patients with dgct who underwent one or multiple surgical interventions during the 10year period from 1997 to 2007. Dentinogenic ghost cell tumor of the peripheral variant. The diagnosis and treatment of dentinogenic ghost cell tumor. Due to the fact that all cgcoc lesions are not cystic, and the biological behavior is often not consistent with a cyst, there has always been a controversy as to whether coc is a cyst or a tumor. On ct and mr studies, the tumor was seen as a large, heterogeneous softtissue mass that caused marked destruction of the mandible and invaded the mouth floor and tongue base. Treatment with enucleation might lead to recurrence of this tumor.
The 2005 who histological classification of odontogenic tumors lays out a classification system for neoplasms and other tumors related to the odontogenic apparatus. Most of them show only faint traces of nuclear material. Dentinogenic ghost cell tumours are extremely rare, posing significant diagnostic and therapeutic challenges. Microscopic appearance of odontogenic epithelium admixed with focal areas of dentinoid formation and sheets of ghost. Ghost cell odontogenic carcinoma gcoc is a rare malignant odontogenic tumor with aggressive growth characteristics. Dentinogenic ghost cell tumor is a rare tumor constituting only. A 41yearold chinese male visited our hospital in 20, with a 4month history of bloody purulent rhinorrhea with a peculiar smell in the right nasal cavity. We report a case of aggressive epithelial odontogenic ghost cell tumor arising from the mandible in a 32yearold man. Few cases of dgct have been reported and only 11 show no bone involvement. Calcifying cystic odontogenic tumor associated to odontoma e490. The dentinogenic ghost cell tumor, journal of oral pathology. In particular, there has been a major attempt to simplify classifications and to use defining criteria which can be used globally in all situations, avoiding wherever possible the use of complex molecular.
Odontogenic tumor group of neoplasm and tumor like malformations arising from cells of odontogenic apparatus and their remnants. Classified as an odontogenic carcinoma, which includes. Dentinogenic ghost cell tumor bafna ss, joy t, tupkari jv. May 10, 2014 the dentinogenic ghost cell tumor comes under the spectrum of ghost cell lesions. In this case report, we report a rare case of gcoc in the mandible which has transformed from an ameloblastoma lesion that was observed 7 years ago, then describe its clinical. Maxillary dentinogenic ghost cell tumour europe pmc. Dentinogenic ghost cell tumor dgct is a rare, odontogenic neoplasm which is considered to be a solid variant of the calcifying odontogenic cyst coc with locally aggressive behavior and is. Pdf pyogenic granuloma mimicking peripheral dentinogenic. Dentinogenic ghost cell tumor dgct is a rare tumorous form of calcifying. A rare case of peripheral dgct is reported, located in the anterior mandible of a 45yearold man. The only effective treatment modality was surgical removal. Dentinogenic ghost cell tumor dgct is an uncommon locally invasive odontogenic tumor regarded by many as a variant of calcifying odontogenic cyst.
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