CASE REPORTS   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2013 April;172(4):297-301

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Clear cell odontogenic carcinoma: a case report with immunohistochemical study and comprehensive literature review

Rivera H. ¹, Bastidas A. ², Jham B. C. ³

¹ Oral Pathology Laboratory, Faculty of Dentistry, Central University of Venezuela, Caracas, Venezuela; ² “Luis Razetti” School of Medicine, Central University of Venezuela, Caracas, Venezuela; ³ College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL, USA

Clear cell odontogenic carcinoma (CCOC) is rare odontogenic tumor first reported in 1985. The aim of this paper was to describe a case of CCOC, describing its immunohistochemical features, and to comprehensively review the literature on previously published cases. A 66-year-old male was referred for evaluation of an asymptomatic, expansile, multilocular lesion in the left posterior mandible. Histopathologic examination revealed a tumor growth with a biphasic pattern, consisting of cells with clear cytoplasm, admixed with eosinophilic polygonal epithelial cells. Interestingly, pseudoepitheliomatous hyperplasia of the overlying mucosa was observed. Immunohistochemical analysis revealed positivity for pankeratin AE1/AE3 and cytokeratins 18/19. Vimentin, desmin, CD68, HMB-45, renal cell carcinoma antigen, S-100 and calponin stains were negative. The patient underwent resection of the lesion and neck dissection. The literature review yielded 82 cases of CCOC. Females were more affected than males (1.5:1 ratio), with a mean age of 55 years. CCOC had a predilection for the mandible, with 76% of the lesions developing in this site, while 24% developed in the maxilla (ratio of 3.3 to 1). Radiographically, the most common finding was an ill-defined lucency, with 93% of the cases presenting with this aspect. Surgery was the most common treatment employed, with radiotherapy and chemotherapy being rarely used.