title: Clear cell odontogenic carcinoma: report of 7 new cases and systematic review of the current knowledge.
abstract: OBJECTIVE
  The goal of this study is to describe 7 cases of clear cell odontogenic carcinoma among a Brazilian population and compare these data with a systematic review of the English-language literature.
  
  
  METHODS
  Descriptive statististics were used to compare the clinicopathologic data gathered retrospectively with those compiled from a review. Tumor sections were immunostained for Ki-67, p16, p53, and cytokeratins (CKs) 7, 8, 14, 18, and 19. Log-rank tests were performed for survival analysis.
  
  
  RESULTS
  Most cases occurred in the posterior mandible (5/7, 71.4%), and recurrence was diagnosed in all treated patients. Metastatic disease occurred in 2 patients (28.6%). Tumors were focally positive for CKs 7, 8, 14, and 18 and diffusely positive for CK19, p53, and p16. The mean number of Ki-67-positive cells was 35.2 cells/high-power field. Our systematic review provided evidence that tumor size (P = .046), histologic pattern (P = .034), regional metastasis (P = .001), distant metastasis (P = .001), and local recurrence (P = .05) were of significant prognostic value.
  
  
  CONCLUSIONS
  This study has contributed to improved characterization of clear cell odontogenic carcinoma, which is an aggressive odontogenic malignant neoplasm diagnosed mainly in the posterior mandible of middle-aged women and typically at an advanced stage. Radical surgical procedures remain the gold standard treatment.
authors.affiliation: Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia, Uberlândia (MG), Brazil. Electronic address: loyolaam@yahoo.com.br.
authors.forename: Adriano Mota
authors.initials: AM
authors.lastname: Loyola
authors.affiliation: Department of Morphology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia (MG), Brazil.
authors.forename: Sergio Vitorino
authors.initials: SV
authors.lastname: Cardoso
authors.affiliation: Department of Morphology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia (MG), Brazil.
authors.forename: Paulo Rogério
authors.initials: PR
authors.lastname: de Faria
authors.affiliation: Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia, Uberlândia (MG), Brazil.
authors.forename: João Paulo Silva
authors.initials: JP
authors.lastname: Servato
authors.affiliation: Department of Oral and Maxillofacial Pathology, Federal University of Uberlândia, Uberlândia (MG), Brazil.
authors.forename: Luiz Fernando
authors.initials: LF
authors.lastname: Barbosa de Paulo
authors.affiliation: Division of Pathology, Brazilian National Institute of Cancer, Rio de Janeiro (RJ), Brazil.
authors.forename: Ana Lúcia Amaral
authors.initials: AL
authors.lastname: Eisenberg
authors.affiliation: Division of Head and Neck Surgery, Brazilian National Institute of Cancer, Rio de Janeiro (RJ), Brazil.
authors.forename: Fernando Luiz
authors.initials: FL
authors.lastname: Dias
authors.affiliation: Department of Pathology, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil.
authors.forename: Carolina Cavalieri
authors.initials: CC
authors.lastname: Gomes
authors.affiliation: Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil.
authors.forename: Ricardo Santiago
authors.initials: RS
authors.lastname: Gomez
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D001938:Brazil / Q000453:epidemiology; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007573:Jaw Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009808:Odontogenic Tumors / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor