Clear Cell Odontogenic Carcinoma-A Review of the Literature

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Clear Cell Odontogenic Carcinoma-A Review of the Literature

Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 3

Abstract

Clear cell odontogenic carcinoma is a rare jaw lesion with predominantly clear cell characteristics. Although touted as a benign lesion in the initial stages, once the aggressive nature of the lesion became evident, it was reclassified as a malignant tumor by the World Health Organization. Etiology of this lesion remains elusive, and association with any precursory lesion is yet to be proved. It may have their origins from odontogenic epithelium, salivary gland pathologies or even as metastasis from distant locations like kidneys. That the ideal treatment plan should be composite resection along with elective neck dissection, followed by reconstruction of the defect. If clinical and radiological examination of the patient reveals, extensive soft tissue invasion, perineural spread, lymph node metastasis with an extra - nodal involvement or in those where tumor-free margins are not possible, then, the use of adjuvant radiation therapy should be considered and employed at the surgeon’s discretion. Even though initial tumor free margins are attained, it is emphasized that the patient should be kept under the long-term follow-up to identify recurrences.Hansen et al. [1] coined the term “clear cell odontogenic tumor” in 1985 when they described an odontogenic epithelialtumor with predominantly clear cell characteristics. Since all their cases were located centrally in the jaws, they contended upon the odontogenic origin of the lesion. Although previously excluded from the World Health Organization (WHO) classifications of odontogenic tumors, its tendency to recur and metastasis is, since then, well documented [2,3]. Therefore, it was agreed upon that “clear cell odontogenic carcinoma” (CCOC) is a more appropriate nomenclature, and Reichart and Philipsen, later, adopted the same in their latest classification of odontogenic tumors approved by the WHO [4]. In 1992 WHO defined CCOC as “A benign but locally invasive neoplasm originating from odontogenic epithelium and characterized by sheets and islands of uniform, vacuolated and clear cells.”Odontogenic tumors, salivary gland tumors (primary or secondary) and metastatic renal carcinomas are considered as differential diagnoses of CCOC. Based on the morphological, immunohistochemical and clinical grounds the latter two were subsequently eliminated from the list. Waldron et al. [5] first observed the resemblance of clear cell odontogenic carcinoma to ameloblastoma due to the presence of focal palisading. In spite of their presence, no other areas exhibited typical ameloblastoma characteristics. The focal palisading later went on to justify the odontogenic origin of this lesion, more so when accompanied by inductive hyalinization of the adjacent fibrous tissue.

Authors and Affiliations

Manoj Kumar KP, Shermil Sayd, Suresh Vyloppilli, Sarfras Raseel

Keywords

Clear Cell Dontogenic Carcinoma; Clear Cell Odontogenic Tumor; Metastatic Clear Cell Odontogenic Carcinoma; Clear Cell Maxillary Carcinoma; Clear Cell Mandibular Carcinoma

EP ID EP570616
DOI 10.26717/BJSTR.2017.01.000274
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