International collaborative study on ghost cell odontogenic tumours: Calcifying cystic odontogenic tumour, dentinogenic ghost cell tumour and ghost cell odontogenic carcinoma

Oral Pathology Department, Facultad de Odontología, Universidad Nacional Autónoma de México, México, DF, México.
Journal of Oral Pathology and Medicine (Impact Factor: 1.87). 06/2008; 37(5):302-8. DOI: 10.1111/j.1600-0714.2007.00623.x
Source: PubMed

ABSTRACT Calcifying odontogenic cyst was described first by Gorlin et al. in 1962; since then several hundreds of cases had been reported. In 1981, Praetorius et al. proposed a widely used classification. Afterwards, several authors proposed different classifications and discussed its neoplastic potential. The 2005 WHO Classification of Odontogenic Tumours re-named this entity as calcifying cystic odontogenic tumour (CCOT) and defined the clinico-pathological features of the ghost cell odontogenic tumours, the CCOT, the dentinogenic ghost cell tumour (DGCT) and the ghost cell odontogenic carcinoma (GCOC).
The aim of this paper was to review the clinical-pathological features of 122 CCOT, DGCT and GCOC cases retrieved from the files of the oral pathology laboratories from 14 institutions in Mexico, South Africa, Denmark, the USA, Brazil, Guatemala and Peru. It attempts to clarify and to group the clinico-pathological features of the analysed cases and to propose an objective, comprehensive and useful classification under the 2005 WHO classification guidelines.
CCOT cases were divided into four sub-types: (i) simple cystic; (ii) odontoma associated; (iii) ameloblastomatous proliferating; and (iv) CCOT associated with benign odontogenic tumours other than odontomas. DGCT was separated into a central aggressive DGCT and a peripheral non-aggressive counterpart. For GCOC, three variants were identified. The first reported cases of a recurrent peripheral CCOT and a multiple synchronous, CCOT are included.
Our results suggest that ghost cell odontogenic tumours comprise a heterogeneous group of neoplasms which need further studies to define more precisely their biological behaviour.

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Available from: Wilson Alejandro Delgado, Aug 31, 2014
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    • "Here, all cases of CCOT were negative for this polypeptide, probably because of the complete absence of squamous differentiation of its epithelium lining. In fact, this tumor is composed of a well-defined basal layer beneath a stellate reticulum-like suprabasal layer, which matches that observed in ameloblastoma and the tooth germ, and even a complete absence of terminal squamous epithelial differentiation [4]. Contradicting this hypothesis, some authors have been suggested squamous differentiation on CCOT pathogenesis because of the detection of Ck13 expression on epithelium lining [15] [17]. "
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    ABSTRACT: Calcifying cystic odontogenic tumors (CCOTs) are benign cystic lesions of odontogenic origin characterized by an ameloblastoma-like epithelium and the presence of a group of cells named ghost cells. The pattern of cytokeratin (Ck) expression on these lesions remains unclear and needs to be clarified. To this end, the expression of Ck6, Ck13, Ck14, Ck18, and Ck19 in the epithelium lining of 7 cases of CCOTs was evaluated by immunohistochemistry. For this, the epithelium lining was divided into 3 distinct regions: basal layer, suprabasal layer, and the compartment composed of ghost cells. In this study, 6 cases (85.7%) were classified as type 1 and 1 (14.3%) as type 4. All cases were negative for Ck13 and Ck18, despite the epithelial layer, as well as in the ghost cells. Ck6 was only positive in the ghost cells. Positivity for Ck14 and Ck19 was found in the basal and suprabasal layers, including the ghost cells. The results showing positivity for Ck14 and Ck19 in all of the analyzed cases reinforce CCOT as being of odontogenic origin, and the restricted expression of Ck6 in the ghost cells may be indicative that these cells suffer an altered differentiation into hair follicles in CCOTs.
    Annals of diagnostic pathology 10/2013; 17(6). DOI:10.1016/j.anndiagpath.2013.07.002 · 1.11 Impact Factor
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    • "[5] Although there is no consensus regarding the classification and the terminology of COC, this benign lesion is categorized as either a cyst or neoplasm (solid). [4] [6] [16] In the cyst variant, three different types may be found: the simple unicystic type, the unicystic odontoma-associated type, and the unicystic ameloblastomatous proliferating type. "
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    ABSTRACT: BACKGROUND: Calcifying cystic odontogenic tumour (CCOT), first described by Gorlin in 1962, accounts for less than 2% of all odontogenic tumours. This rare cystic odontogenic lesion, sometimes referred to as the 'keratinizing and calcifying odontogenic cyst', is characterized by the presence of 'ghost' epithelial cells and by its resemblance to the pilomatrixoma of the skin. CASE: In this report, we present a rare case of calcifying odontogenic cyst mimicking as a residual cyst in the maxillary anterior region, in a 60-year-old female patient. The lesion was surgically removed. After enucleation, no recurrence has been recorded. CONCLUSION: Correlation of clinical and radiological information with histological features is important in the diagnosis of odontogenic tumours and cysts.
    Journal of Clinical and Diagnostic Research 09/2010; · 0.23 Impact Factor
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    • "Histopathologically, our case has been diagnosed as ameloblastomatous CCOT due to the ghost cells in the ameloblastomatous epithelial islands [9], and it fits into the category of cystic CGCOT, as suggested by Toida [13], or CCOT type III (ameloblastomatous) [6]. Since, only 15 months have passed from the surgery of the reported case, and the short follow up time, no real conclusion would be drawn regarding the recurrence. "
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    ABSTRACT: ABSTACT In agreement with the new classification of the World Health Organization (WHO) 2005, calcifying odontogenic cyst (COC) or calcifying cystic odont-ogenic tumor (CCOT) is an uncommon developmental odontogenic lesion that demonstrates histopathologic diversity. Predominantly, it occurs in the anterior region of the mouth and in the second and third decades of life. Odontogenic tumors such as ameloblastoma have been reported to be associated with CCOT. In this paper, we report a case of ameloblastomatous CCOT in a boy with involvement of mandibular ramus-an extremely rare histologic variant. The microscopic examination revealed a CCOT; ghost cell within ameloblastic islands in the connective tissue wall was observed.
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