A peripheral dentinogenic ghost cell tumor: A case report

Abstract

Dentinogenic ghost cell tumors (DGCTs) are extremely rare, accounting for less than 0.5% of all odontogenic tumors. DGCTs were described initially as solid neoplasms of calcifying odontogenic cysts (COCs). In the 2005 WHO Histological Classification of Odontogenic Tumors, COCs were classified as tumors and renamed as calcifying cystic odontogenic tumors (CCOTs). The term of DGCT was retained and histologically defined as a locally invasive neoplasm characterized by ameloblastoma-like islands of epithelial cells in a mature connective tissue stroma, aberrant keratinization comprised of ghost cells, and an association with dysplastic dentin. DGCTs were subdivided into two variants: intraosseous (central) and extraosseous (peripheral). Generally, peripheral DGCTs occur less frequently than central ones. We report a rare case of a peripheral DGCT in a 60-year-old man with a well-circumscribed nodule in the left canine region of the maxilla. The lesion measured about 11 millimeters in diameter. No bone involvement was observed radiographically. Based on clinical and radiographic findings, the tumor was provisional diagnosed as benign. Consequently, it was enucleated completely, and a histopathological diagnosis of DGCT was made. The patient has remained disease-free for 18 months postoperatively. The biologic behavior of central DCGTs is considered to be more aggressive and require radical treatment. In contrast, peripheral DGCTs have been reported to be non-aggressive, because local bone resorption or recurrences have not yet been reported. There are no differences in the histopathologic features between the central and peripheral variants. Accordingly, accurate preoperative evaluation is crucial to differentiate between these lesions including other odontogenic tumors.