title: Calcifying ghost cell odontogenic tumor (CGCOT) with predominance of clear cells: a case report with important diagnostic considerations.
abstract: An 18-year-old female reported painful swelling in the left maxillary region 4 months after the extraction of tooth #15. Because incisional biopsy suggested ameloblastoma with clear-cell changes, segmental resection was performed. The microscopic examination of the excised tissue revealed histomorphologic diversity, with features of typical calcifying ghost cell odontogenic tumor (CGCOT) and a significant clear-cell component constituting more than 50% of the tumor mass without any features of malignancy. Clear cells were periodic acid-Schiff (PAS) positive and mucicarmine negative. CK19 was strongly positive in the solid tumor islands and variably positive in clear cells. A definitive diagnosis of CGCOT with predominance of clear cells was confirmed. Because both squamous metaplasia and clear-cell components were present in the ameloblastic follicles independent of each other, the presence of abundant calcifications favored the diagnosis of CGCOT with a clear-cell component over that of an ameloblastoma with clear-cell changes. The importance of identifying the histomorphologic features of the 2 entities, ameloblastoma and CGCOT, is highlighted. This appears to be the second case reported in the literature, to the best of our knowledge.
authors.affiliation: Professor and Head, Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India. Electronic address: draadithyaburs@gmail.com.
authors.forename: Aadithya B
authors.initials: AB
authors.lastname: Urs
authors.affiliation: Associate Professor, Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
authors.forename: Jeyaseelan
authors.initials: J
authors.lastname: Augustine
authors.affiliation: Senior Resident, Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
authors.forename: Hanspal
authors.initials: H
authors.lastname: Singh
authors.affiliation: Postgraduate Student, Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
authors.forename: Kirti
authors.initials: K
authors.lastname: Kureel
authors.affiliation: Professor and Head, Department of Oral & Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Mohanty
authors.affiliation: Associate Professor, Department of Oral Medicine & Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
authors.forename: Shalini
authors.initials: S
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008441:Maxillary Neoplasms / Q000473:pathology* / Q000601:surgery*; D018333:Odontogenic Cyst, Calcifying / Q000473:pathology* / Q000601:surgery*