DENTINOGENIC GHOST CELL TUMOR WITH FOCAL FEATURES SUGGESTING GHOST CELL ODONTOGENIC CARCINOMA: A CHALLENGING DIAGNOSIS

Abstract

Dentinogenic ghost cell tumor and ghost cell odontogenic carcinoma form a spectrum of rare benign and malignant odontogenic neoplasms, respectively. A 24-year-old White woman complained of a painful enlargement and dental mobility in the maxilla for approximately 1 year. An intraoral examination showed a 3 × 3 cm firm exophytic mass in the left molar region. Tomographic sections showed a well-defined hypodense expansion with hyperdense foci inside invading the maxillary sinus. Microscopically, incisional sections showed a predominantly solid basaloid epithelium presenting atypical features, mitotic activity, ghost cells, positivity for p53, and high Ki-67 labeling, suggesting malignancy. Partial maxillectomy was performed. Surprisingly, the surgical specimen presented an important variation of the epithelial pattern and lacked any sign of malignancy, with abundant ghost cells and dentinoid, confirming the diagnosis of dentinogenic ghost cell tumor. A strict regular follow-up was done with no signs of recurrence or metastasis over 2 years.