An intraosseous sclerosing odontogenic tumor predominantly composed of epithelial cells: relation to (so-called) sclerosing odontogenic carcinoma and epithelial-rich central odontogenic fibroma.
We report a case of an asymptomatic sclerosing odontogenic tumor in a 31-year-old woman. Radiologically, the tumor was well circumscribed, was predominantly radiolucent, and had a peripheral sclerotic margin. Histopathologically, the tumor showed small clusters, strands, and cords of small to medium-sized epithelial tumor cells in a sclerotic collagenous stroma. Immunohistochemically, the tumor cells were positive for broad-spectrum cytokeratins (CKs) (CK7, CK5/6, CK19, and CAM 5.2) and p63. Membranous staining for E-cadherin was present. There was weak to moderate nuclear expression of p16 in 30% of cells. Rare tumor cells were positive for p53. Progesterone receptors were expressed in about 60% of the tumor cells. The proliferative activity (Ki-67) was approximately 2%. A molecular genetic (fluorescence in situ hybridization) study showed no EWSR1 (EWS RNA-binding protein 1) gene rearrangement. No recurrence or metastatic events have been documented at 1-year follow-up. This tumor represents a classification dilemma mainly between epithelial-rich central odontogenic fibroma and the so-called sclerosing odontogenic carcinoma.
Registrar, Department of Pathology, National University Health System, Singapore.
Sze Hwa
SH
Tan
Associate Professor, Senior Consultant, Department of Oral and Maxillofacial Surgery, National University Health System, Singapore.
Jin Fei
JF
Yeo
Consultant, Department of Pathology, National University Health System, Singapore.
Brendan Nghee
BN
Kheem Pang
Associate Professor, Senior Consultant, Department of Pathology, National University Health System, Singapore. Electronic address: Fredrikpetersson@live.se.
Fredrik
F
Petersson
D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008339:Mandibular Neoplasms / Q000473:pathology* / Q000601:surgery*; D009808:Odontogenic Tumors / Q000473:pathology* / Q000601:surgery*; D011862:Radiography, Panoramic
D014408:Biomarkers, Tumor