Intraosseous mandibular clear cell odontogenic carcinoma with predominant small round blue cells: a potential diagnostic pitfall.

Autor: Koga S; Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: shunsuke.koga@pennmedicine.upenn.edu., Gates JC; Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Peters SM; Department of Pathology and Oral Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, Pennsylvania, USA., Cooper K; Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Oral surgery, oral medicine, oral pathology and oral radiology [Oral Surg Oral Med Oral Pathol Oral Radiol] 2024 Dec; Vol. 138 (6), pp. e120-e124. Date of Electronic Publication: 2024 Aug 05.
DOI: 10.1016/j.oooo.2024.07.009
Abstrakt: Objective: Clear cell odontogenic carcinoma (CCOC) is a rare malignancy of the jaw, presenting significant diagnostic challenges. This report aims to highlight the complexities associated with biopsy-based diagnoses of oral and maxillofacial lesions, as demonstrated in a case of intraosseous mandibular CCOC initially suggestive of Ewing's sarcoma due to its presentation with small round blue cells.
Results: The patient, a 37-year-old male, presented with a mandibular lesion that on incisional biopsy was suggestive of Ewing's sarcoma. Subsequent, comprehensive histologic evaluation after definitive resection via mandibulectomy revealed a CCOC, characterized by a biphasic pattern of clear and basaloid cells. Histological examination confirmed the presence of glycogen-rich clear cells, supported by periodic acid-Schiff (PAS) staining and confirmed by PAS diastase staining, which demonstrated glycogen digestion. Immunohistochemistry was positive for AE1/AE3, p40, and p63, while negative for c-kit and CD34, confirming CCOC and excluding other malignancies such as Ewing's sarcoma, which would have been treated with neoadjuvant chemotherapy instead of primary surgical treatment as in CCOC.
Conclusion: This case highlights the essential need for thorough histopathological evaluation and the value of a second opinion via additional histologic consultation, particularly due to the diagnostic challenges of heterogeneous lesions in the oral and maxillofacial region.
Competing Interests: Declarations of Interest None declared.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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