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Different manifestations of calcifying cystic odontogenic tumor  [PDF]
Estevam Rubens Utumi,Irineu Gregnanin Pedron,Leopoldo Penteado Nucci da Silva,Gustavo Grothe Machado
Einstein (S?o Paulo) , 2012,
Abstract: The calcifying cystic odontogenic tumor normally presents as apainless, slow-growing mass, involving both maxilla and mandible,primarily the anterior segment (incisor/canine area). It generallyaffects young adults in the third to fourth decades, with no genderpredilection. Computerized tomography images revealed importantcharacteristics that were not detected by panoramic radiography,such as fenestration, calcification and tooth-like structures. Thetypical microscopic feature of this lesion is the presence of variableamounts of aberrant epithelial cells, without nuclei, which arenamed “ghost cells”. In addition, dysplastic dentine can be foundand occasionally the cyst can be associated with an area of dentalhard tissue formation resembling an odontoma. The treatment forcalcifying cystic odontogenic tumor involves simple enucleationand curettage. The purpose of this article is to present two differentmanifestation of calcifying cystic odontogenic tumor in whichcomputerized tomography, associated to clinical features, servedas an important tool for diagnosis, adequate surgical planning andfollow-up of patients.
Intraosseous calcifying cystic odontogenic tumor  [cached]
Kler Shikha,Palaskar Sangeeta,Shetty Vishwa,Bhushan Anju
Journal of Oral and Maxillofacial Pathology , 2009,
Abstract: The calcifying odontogenic cyst was first reported by Gorlin et al . in 1962. It had been classified as a neoplasm related to the odontogenic apparatus because of its histological complexity and morphological diversity until it was renamed as a calcifying cystic odontogenic tumor by the WHO, in 2005. Here we describe a case of mandibular calcifying cystic odontogenic tumor in a 75-year-old male, which was present since five years, with a history of occurrence after the extraction of teeth in the involved region. The lesion was surgically removed and a histopathological examination revealed a cystic tumor with predominance of ghost cells and some amount of dentinoid tissue.
Calcifying cystic odontogenic tumor- a unique developmental lesion arising in mandible  [PDF]
S Vasudev,VP Singh,R Jhawar,DK Roy
Health Renaissance , 2012, DOI: 10.3126/hren.v10i1.6012
Abstract: Calcifying cystic odontogenic tumor (CCOT) is a unique developmental lesion arising from the odontogenic epithelial remnants present in the jaw bones. It is a very rare lesion having a distinctive histopathologic appearance characterized by the presence of ghost cells with considerable amount of histopathologic diversity. The case report describes a rare and unusually large presentation of CCOT in an 18 year old female. The patient presented with a large swelling in the mandibular’ anterior region. After clinical, radiographic investigations, an incisional biopsy was performed and a diagnosis of CCOT was made. The cyst was enucleated with complete removal of cystic lining. The patient has recovered well and has been kept under observation. DOI: http://dx.doi.org/10.3126/hren.v10i1.6012 HREN 2012; 10(1): 64-68
A pigmented calcifying cystic odontogenic tumor  [cached]
Yasemin ?ZLüK,Yersu KAPRAN,Ahmet Bülent KAT?BO?LU,Cem TANYEL
Türk Patoloji Dergisi , 2007,
Abstract: A case of a pigmented calcifying cystic odontogenic tumor (CCOT) localized in the mandible occuring in a 16-year-old white female - is reported, and the characteristic histomorphologic features of CCOT and the pathogenesis of melanin and melanocytes present in the pigmented type is discussed under the light of histochemical and immunohistochemical data.
A unique case of a calcifying cystic odontogenic tumor  [PDF]
Shoko Gamoh, Yukako Nakashima, Hironori Akiyama, Kimishige Shimizutani, Takuro Sanuki, Junichiro Kotani, Koji Yamada, Shosuke Morita, Kazuya Tominaga, Masahiro Wato, Akio Tanaka
Open Journal of Stomatology (OJST) , 2013, DOI: 10.4236/ojst.2013.36052

The calcifying odontogenic cyst was first reported by Gorlin et al. in 1962. At that time, it was classified as a cyst related to the odontogenic apparatus, although it was later renamed as a calcifying cystic odontogenic tumor by the WHO calcification in 2005 due to its histological complexity, morphological diversity and aggressive proliferation [2]. Here, we describe a case of a calcifying cystic odontogenic tumor in a 4- year-old boy. The lesion was surgically removed, and the histopathological examination revealed it to be a cystic tumor with ghost cells, a stellate reticulum and small amount of dentinoid tissue in the cystic wall.

Ultrasonographic Evaluation of Calcifying Cystic Odontogenic Tumor: A Case Report
F Ezoddini-Ardakani,S Nayer,MR Mokhtare
Journal of Shahid Sadoughi University of Medical Sciences , 2012,
Abstract: The Calcifying Cystic Odontogenic Tumor(CCOT) is an uncommon lesion that demonstrates considerable histopathologic diversity and variable clinical behavior. A CCOT is rarely found in everyday practice. According to Kramer and Pindborg as well as majority of other authors’ classification, since 1992 the World Health Organization favored the use of the term calcifying cystic odontogenic tumor, described it as a cystic or neoplastic-like odontogenic pathological lesion of the jaw, and classified it as a benign odontogenic tumor. Ultrasonography(USG) is an inexpensive, non-invasive, and almost an available technique that is well tolerated by patient. In recent years many investigations focused on the use of ultrasonography in maxillofacial region as well as in intra osseous lesions of the jaws. This paper describes a 34 year old female with a painless mild swelling in the left anterior maxillary region associated with an impacted lateral incisor. The Panoramic, lateral occlusal and periapical view findings showed well-defined corticated unilocular mixed lesion with cluster of small pebbles calcifications. USG examination, using linear probe transducer, and also evaluation of location, size, internal echoe and boundary of the tumor were performed and documented. The main USG features of the tumor appeared as anechoic pattern cystic like lesion with some calcifying contents. Pathologic diagnosis was obtained by examining the surgical specimen. Therefore, ultrasonography may be used as an effective supplementary diagnostic tool for maxillofacial lesions.
Pindborg Tumor in an Adolescent-An Atypical Presentation
Kafil Akhtar, Nazoora Khan, Sufian Zaheer, Rana K Sherwani,,S Abrar
JK Science : Journal of Medical Education & Research , 2009,
Abstract: Calcifying epithelial odontogenic tumor (Pindborg tumor), is a rare benign odontogenic neoplasm representingabout 0.4-3% of all odontogenic tumors. This tumor more frequently affects adults in an age range of 20-60 years, with a peak incidence in the 5th decade of life. Calcifying epithelial odontogenic tumour has amuch lower recurrence rate than ameloblastoma and malignant transformation with metastasis is rare.
Notch signaling and ghost cell fate in the calcifying cystig odontogenic tumor
CH Siar, T Kawakami, RR Buery, K Nakano, M Tomida, H Tsujigiwa, PP Han, H Nagatsuka, HK Ng
European Journal of Medical Research , 2011, DOI: 10.1186/2047-783x-16-11-501
Abstract: Notch signaling is an evolutionarily conserved mechanism that enables adjacent cells to adopt different fates [1]. The Drosophila Notch gene encodes a transmembrane receptor with a large extracellular domain carrying multiple epidermal growth factor-like repeats and a cytoplasmic domain required for signal transduction [1]. In vertebrates, there are four Notch receptor proteins (Notch1, Notch2, Notch3, and Notch4) and five membrane-bound ligand proteins (Delta1, Delta2, Delta4, Jagged1, and Jagged2) [1]. Signals exchanged between neighboring cells through binding of ligand with its cognate receptor initiates short range events including differentiation, proliferation, and apoptotic events at all stages of development, thus controlling organ formation and morphogenesis [1]. Deregulation of Notch signaling has been implicated in developmental abnormalities and neoplasias [2].Ghost cells are large pale anucleate cells with homogeneous pale eosinophilic cytoplasm and very pale to clear central areas instead of a basophilic nucleus [3]. They tend to form small clusters or large masses. Although characteristic of calcifying cystic odontogenic tumors (GGoT) [4], ghost cells are also found in other odontogenic lesions namely ameloblastoma [5] odontoma [6] and ameloblastic fibro-odontoma [7], and in nonodontogenic tumors such as pilomatrixoma [8], a tumor with hair matrix cell differentiation, and craniopharyngioma, a tumor of the pituitary gland [9]. Several theories of ghost cell formation have been put forth including that these cells are most likely abnormal keratinized bodies, or they might represent simple cell degeneration or a form of enamel matrix; or might be apoptotic odontogenic cells or represent different stages of normal and abnormal keratin formation resulting from metaplastic transformation of odontogenic tumors [4]. The World Health Organization Classification of Head and Neck Tumors considered ghost cells as transitory squamous cells at various stages of d
A pigmented calcifying cystic odontogenic tumor associated with odontoma: A case report
Gh Jahanshahi,Sh Tabatabaei Ardakani
Journal of Isfahan Dental School , 2009,
Abstract: Introdution: Pigmented intraosseous odontogenic lesions are rare, with only 47 reported cases inthe English literature. Among them, pigmented calcifying cystic odontogenic tumor, formerly knownas calcifying odontogenic cyst, is the most common lesion with 20 reported cases.Case Report: The patient was a 19-year-old man. He had a bony, tender expansion in anteriorright maxillary region extended to orbital rim with visual complaints and unilateral headache.Considering radiographic appearance, microscopic study, special and immunohistochemicalstaining, a diagnosis of pigmented calcifiying cystic odontogenic tumor associated with odontomawas rendered.Conclusion: Due to the same neural crest origin for melanocytes and dental lamina, the presenceof melanocytes and melanin in this lesion is accountable. However, till now, no biologic behavioraland prognostic role has been considered for it. This case will add to rare reported cases ofpigmented odontogenic lesions.Key words: Pigmented calcifying cystic odontogenic tumor, Odontoma, Melanocyte
Predictive Factors of Potential Malignant Transformation in Recurrent Calcifying Cystic Odontogenic Tumor: Review of the Literature  [PDF]
Sepideh Mokhtari,Zhaleh Mohsenifar,Maedeh Ghorbanpour
Case Reports in Pathology , 2013, DOI: 10.1155/2013/853095
Abstract: 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. In this paper, we present a case of CCOT and discuss its distinct histopathologic features in recurrence. Then, we will have a review on clinical, histopathological, and immunohistochemical aspects of GCOC in the literature. Predictive factors of malignant transformation in a benign CCOT will also be discussed. 1. Introduction Calcifying odontogenic cyst (COC) represents 2% of all odontogenic lesions in the jaw [1]. It demonstrates considerable diversity in histopathology and clinical behavior. Latest subclassification of World Health Organization (WHO) has renamed this lesion as calcifying cystic odontogenic tumor (CCOT) [2]. Ghost cell odontogenic carcinoma (GCOC) is the malignant counterpart of this tumor and it frequently arises from malignant transformation of CCOT after multiple recurrences [3]. Here, we present a case of recurrent CCOT and discuss its distinct histopathologic features as potential predictive factors of future malignancy. We will also have a review on clinical, histopathological, and immunohistochemical characteristics of GCOC in the literature. 2. Case Presentation A 54-year-old male presented with swelling in the right side of mandible. He had a history of right first molar extraction 5 years ago with subsequent abscess formation and without any treatment. Radiographic examination revealed a multilocular radiolucent lesion (Figure 1). Root resorption of right mandibular canine and premolars was also obvious. Incisional biopsy revealed a benign cystic lesion with typical histologic features of calcifying odontogenic cyst (Figure 2). The lesion was excised and extensively curetted. Serial panoramic radiographs were taken in 2-week, 3-, 11-, 13-, and 18-month follow-up (Figures 3 and 4). Continuous healing process was seen in panoramic views. However, in all radiographs a nonhealing radiolucent area with progressive increase in size was evident. This area was apparent in the radiograph of 18-month follow-up as a well-defined radiolucent lesion. Clinical examination revealed a swelling in the right side of mandible measuring 4 × 3?cm. The surface skin was intact with no erythema or tenderness and the patient had no lymphadenopathy. In computed tomographic sections, buccal and lingual cortex perforations were evident. Tumor recurrence was confirmed by
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