ODONTOGENIC TUMOR WITH AN UNCERTAIN DIAGNOSIS: A CASE REPORT

Abstract

Background The calcifying odontogenic cyst is an uncommon lesion with an incidence of 1% of all odontogenic cysts and tumors. It is characterized microscopically by ameloblastoma-like odontogenic epithelial proliferation, presence of ghost cells, and dentinoid-like material. It was previously described by Gorlin et al. in 1962 and because of its diverse histologic picture, several terms have been used over time by different authors to describe this lesion. Case Report This is a case report on a variant of the calcifying odontogenic cyst. A 47-year-old male patient attended the Oral and Maxillofacial Surgery Department with an overgrowth of inflamed tissue and exophytic appearance on the gingivae in the lower right molar region. Initial imaging revealed a uniloculated and well-circumscribed osteolytic lesion in the edentulous area of the lower first molar. The histopathologic examination of the incisional biopsy sample did not establish a definitive diagnosis. Differential diagnosis included calcifying odontogenic tumor and adenomatoid odontogenic tumor. The patient underwent complete resection of the tumor along with the adjacent molar under general anesthesia. No postoperative complications were encountered. A lesion comprising keratin with ghost cells and calcification was sampled. It appears to be continuous with the surface epithelium and not present in the bone. The presence of ameloblastic cells at the periphery of the calcified foci led to the diagnosis of the controversial lesion known as Gorlin cyst and more recently as dentinogenic ghost cell tumor. One year after the resection, no clinical or radiological recurrence was observed. Yearly follow-ups are planned.