Clear cell odontogenic carcinoma: case report with immunohistochemical findings adding support to the challenging diagnosis

Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis, and low survival. We report a case of CCOC affecting the mandible of a 39-year-old man. The tumor presented a biphasic pattern composed of clear cell nests intermingled with...

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Published in:Oral surgery, oral medicine, oral pathology, oral radiology and endodontics oral medicine, oral pathology, oral radiology and endodontics, 2008-09, Vol.106 (3), p.403-410
Main Authors: Xavier, Flávia Caló Aquino, DDS, MSc, Rodini, Camila Oliveira, DDS, MSc, Ramalho, Luciana Maria Pedreira, DDS, PhD, Sarmento, Viviane Almeida, DDS, PhD, Nunes, Fabio Daumas, DDS, PhD, de Sousa, Suzana Cantanhede Orsini Machado, DDS, PhD
Format: Article
Language:English
Subjects:
Adenocarcinoma, Clear Cell - pathology
Adult
Biological and medical sciences
Dentistry
Humans
Keratins - analysis
Male
Mandibular Neoplasms - pathology
Medical sciences
Mucin-1 - analysis
Odontogenic Tumors - pathology
Otorhinolaryngology. Stomatology
Surgery
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Summary:Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor associated with aggressive clinical behavior, metastasis, and low survival. We report a case of CCOC affecting the mandible of a 39-year-old man. The tumor presented a biphasic pattern composed of clear cell nests intermingled with eosinophilic cells and separated by collagenous stroma. Immunoreactivity to cytokeratin (CK), specifically AE1/AE3 and CK 8, 14, 18, and 19 was found, as well as to epithelial membrane antigen (EMA). The tumor cells were negative for S100 protein, CK 13, vimentin, smooth muscle actin, laminin and type IV collagen. Low labeling indices for the proliferation markers Ki-67 and proliferating cell nuclear antigen and to p53 protein might predict a favorable prognosis for the lesion. A surgical resection was performed, followed by adjuvant radiotherapy. A 2-year follow-up has shown no signs of recurrence. The significance of histochemical and immunohistochemical resources in the correct diagnosis of CCOC is analyzed.
ISSN:1079-2104
1528-395X
DOI:10.1016/j.tripleo.2008.03.010