Calcifying epithelial odontogenic tumor showing microscopic features of potential malignant behavior.
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign, but locally aggressive, odontogenic tumor, and only 2 cases of malignant CEOT are reported in the literature. We describe a case of an atypical CEOT that penetrates the blood vessels, invades bone, and perforates the cortical plates of the mandible. On histologic examination, it shows marked pleomorphism and numerous mitotic figures, including a tripolar mitotic figure. Proliferating activity was found to be 5 times higher than typical CEOTs as demonstrated by the proliferating index, Ki-67, and analyzed by a computerized image analysis system. The Ki-67 labeling index of this case was also compared to various previously reported benign and malignant neoplasms. Although there is no clinical finding of metastasis, we believe this neoplasm has malignant potential on the basis of the histologic features of vascular invasion, significant mitotic activity, atypical mitotic figures, and an increased proliferating index.
Cheng
Yi-Shing Lisa
YS
Oral and Maxillofacial Pathology, Diagnostic Sciences, Baylor College of Dentistry-Texas A&M University System, Health Science Center, Dallas, TX 75246, USA. ycheng@tambcd.edu
Wright
John M
JM
Walstad
William R
WR
Finn
Maxwell D
MD
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008339:Mandibular Neoplasms / Q000473:pathology*; D008940:Mitotic Index; D009808:Odontogenic Tumors / Q000473:pathology*
D019394:Ki-67 Antigen