Cases reported "Odontogenic Tumors"

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1/10. Clear cell odontogenic tumor in the mandible: report of a case with duct-like appearances and dentinoid induction.

    A case of clear-cell odontogenic tumor with unusual histological features is presented. A 61-year-old Japanese man was admitted because of swelling of the left premolar-molar region of the mandible. Radiological examination revealed a multilocular radiolucency with irregular margins. Histological examination of the resected specimen showed infiltrative proliferation of both clear and eosinophilic cells into the adjacent soft tissue without encapsulation, suggesting the malignant potential of the tumor. The tumor cells sporadically formed cystic lesions. In addition, several tumor cell nests showed duct-like characteristics, and many eosinophilic dentin-like structures were attached to the tumor cell nests, suggesting the potential for epithelial-mesenchymal induction. Histochemically, the clear tumor cells possessed cytoplasmic glycogen granules. Both clear and eosinophilic tumor cells showed positive immunoreactivities for cytokeratin 19, epithelial membrane antigen and filaggrin, indicating an odontogenic epithelial origin.
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2/10. Clear cell odontogenic carcinoma. Report of two cases and review of the literature.

    This study reviews the literature and reports on the morphologic and immunophenotypic features of 2 clear cell odontogenic carcinomas occurring in the mandible of elderly women, showing extensive infiltration into adjacent tissues. The tumor cells were large, with clear cytoplasm, and arranged in irregular sheets. Some of the latter demonstrated a peripheral rim of cells with eosinophilic cytoplasm or included duct-like structures. There was no evidence of ameloblastic differentiation. Most cells contained glycogen granules and were immunoreactive for cytokeratins and epithelial membrane antigen. In the differential diagnosis other clear cell odontogenic, salivary gland, and metastatic tumors should be considered. Both cases were treated with surgical excision, and the patients are free of disease after 3 and 5 years, respectively. In the literature, however, variable behavior of these tumors has been reported, including recurrence and metastases. It is recommended that terms such as clear cell ameloblastoma and clear cell odontogenic tumor not be used to describe such tumors.
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3/10. Pigmented intraosseous odontogenic carcinoma of the maxilla: a pediatric case report and differential diagnosis.

    We report a pigmented intraosseous odontogenic carcinoma of the maxilla occurring in a 6-year-old Japanese boy. Grossly, the tumor showed solid, gray-yellow, and markedly pigmented appearance. histology showed neoplastic growths of atypical epithelial cells that occasionally contained melanin pigments. melanocytes with dendritic processes were often found in the tumor cell clusters, and solitary or aggregated melanophages were scattered within the dense fibrovascular stroma. The tumor cells were diffusely positive for cytokeratins and epithelial membrane antigen, and focally positive for vimentin, neuron specific enolase, neurofilament protein, carcinoembryonic antigen, and amelogenin. Ultrastructural studies showed well-developed intercellular junctions, mainly desmosomes, and glycogen particles. In addition, some tumor cells contained melanosomes and/or a few neurosecretory granules. We consider that the present tumor suggests a close association of ectoderm, mesenchyma, and neuroectoderm in embryogenesis of the tooth, and can raise a diagnostic confusion with melanotic neuroectodermal tumor.
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4/10. Cytogical features of calcifying epithelial odontogenic tumor (Pindborg tumor) with abundant cementum-like material.

    Calcifying epithelial odontogenic tumor (CEOT) is a rare tumor, most frequently occurring in the mandible and composed of large sheets of epithelial cells, sometimes showing nuclear pleomorphism. This paper was aimed at reporting of the cytological features of an unusual case of CEOT, affecting a 14-year-old female, with abundant deposition of intercellular calcified material. The cytological preparations were characterized by large clusters of scarcely cohesive, large polyhedral cells and abundant calcified material. The latter consisted of intensely basophilic substance either in large clusters or discrete concretions and, at high-power view, occasional tumor cells also contained calcified material. Histologically, the uncalcified stroma displayed focal congo red positivity with the typical birefringence under polarized light. The neoplastic cells were consistently immunoreactive for epithelial membrane antigen, vimentin and, to a lesser extent, for wide spectrum cytokeratins (AE1 AE3) and cytokeratins 8-18 and 19. The cytological features of CEOT are rather characteristic, and the detection of intra- and extracellular calcifications may help to differentiate this neoplasm from others that most commonly arise in this area.
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5/10. Central granular cell odontogenic tumor: immunohistochemistry and ultrastructure.

    Central granular cell odontogenic tumors are rare, with only 30 cases having been reported. The tumors usually occur in the mandibular molar area and are seen as localized painless swellings in patients older than 40 years. We report an additional case that occurred in the posterior mandible of an elderly black woman. All reported cases of this tumor are benign, and cure is effected by localized surgical excision. Ultrastructurally, the cells contain numerous lysosomes and phagocytic vacuoles. Immunohistochemically, the granular cells were positive for vimentin, CD68, muramidase, carcinogenic embryonic antigen, and bcl-2. These features support a mesenchymal origin with a possible histiocytic lineage for the granular cells. awareness of the occurrence of this neoplasm is important to promote detection and differentiation from other intraoral granular cell lesions.
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6/10. Ameloblastic fibrosarcoma of the right mandible: immunohistochemical and electron microscopical investigations on one case, and a review of the literature.

    A case of a 7-year-old girl with ameloblastic fibrosarcoma of the right mandible is described. Immunohistochemical techniques (detection of intermediate filaments, tissue polypeptide antigen, lactoferrin, lysozyme, factor viii-related protein, S-100 protein, carcinoembryonic antigen, alpha-foeto-protein, "lectin-receptors") and electron microscopy were applied. The epithelial part of the tumor, which was positive for keratin, showed distinct tonofilaments in electron microscopy. In contrast, the mesenchymal part was vimentin positive. The cells displayed the ultrastructural features of fibroblasts. The observations are compared with those reported in the literature.
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7/10. Calcifying epithelial odontogenic tumour: a case showing features of malignancy.

    A case of malignant calcifying epithelial odontogenic tumour is reported in a 75-year-old man. Evidence of local tissue invasion and lymph-node metastasis is presented. Immunoperoxidase studies of the neoplastic cells and tumour amyloid were negative for a variety of antigens, including the epithelial markers CEA and keratin. The histological and clinical findings are discussed.
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8/10. Clear cell odontogenic carcinoma in the mandible: histochemical and immunohistochemical observations with a review of the literature.

    A rare case of clear cell odontogenic carcinoma was investigated using histochemical and immunohistochemical methods. The tumor occurred in the anterior mandible of a 69-year-old Japanese man. Histologically, the tumor was composed mostly of large clear cells and squamous cells. Columnar-shaped cells with basophilic nuclei polarized away from the basement membrane were observed at the periphery of the tumor foci. The tumor cells had aggressively invaded muscle and perineural tissues. The tumor cells were positive for PAS staining. Immunohistochemically, tumor cells reacted positively to keratin, cytokeratin19, epithelial membrane antigen, and S-100 protein. The tumor was diagnosed as a clear cell odontogenic carcinoma. Its characteristics are discussed in term of its histopathological, histochemical and immunohistochemical features.
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9/10. Clear cell odontogenic tumour: a case with induction of dentin-like structures?

    A case of clear cell odontogenic tumour, which occurred centrally in the mandible of a 56-year-old Japanese woman, is reported with its histochemical, immunohistochemical and ultrastructural findings. Histologically, the tumour nests were composed of large glycogen-rich clear cells and small non-clear polygonal cells and were separated by thin mature fibrous connective tissue septae. Immunohistochemically, both types of tumour cells showed positive expression of various cytokeratins, in particular cytokeratin 19, and of epithelial membrane antigen. Eosinophilic hyaline deposits and possible dentin-like structures were occasionally formed in contact with the epithelial nests and are regarded as indicative of the epithelial-mesenchymal inductive capacity of this tumour. The aggressive nature of the present tumour was assumed through its invasive growth pattern and occasional mitotic figures. Although it was diagnosed as clear cell odontogenic tumour according to the present WHO classification, the patient must be followed carefully because of its probable malignant nature.
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10/10. Central hyalinizing clear cell carcinoma of the mandible and the maxilla a clinicopathologic study of two cases with an analysis of the literature.

    We describe two cases of primary intraosseous hyalinizing clear cell carcinomas of the jaws. One tumor arose in the mandible, the other in the maxilla. Both patients were adult women. Histologically, both tumors were characterized by a population of clear, glycogen-rich cells arranged in solid nests, trabeculae, and occasional single files, surrounded by a markedly hyalinized fibrous stroma. In close admixture with the clear cells, a second component of smaller cells having eosinophilic cytoplasms was also noted. Focal areas of squamous metaplasia were seen in one of the tumors. Neither nuclear pleomorphism nor mitotic activity were conspicuous features. Mucicarmine stains were negative in both tumors. Immunohistochemically, the tumor cells expressed cytokeratins and epithelial membrane antigen. Stains for S100 protein, smooth muscle specific actin, and carcinoembryonic antigen were all negative. Both patients are alive and well 14 and 17 months respectively after the diagnosis without evidence of metastasis or recurrence. The major importance of recognizing the existence of this rare form of salivary gland-type adenocarcinoma arising as a primary lesion in the mandible or the maxilla lies in avoiding misdiagnosing it as other primary or metastatic clear cell neoplasms, including various odontogenic clear cell tumors, other primary intraosseous salivary gland tumors, and metastatic clear cell adenocarcinomas from other organs, particularly the kidney.
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