PP036: Clear cell odontogenic carcinoma – A case report

Abstract

Clear cell odontogenic carcinoma (CCOC) is a rare malignant neoplasm, originating from odontogenic epithelium. In this report, we present a case of CCOC of the maxilla of a 63-year-old male patient. The patient with the medical history of Thromboangiitis obliterans and hypertension had received limp amputation due to his ailment. Intraoral examination of the patient revealed spontaneous oroantral perforation in the premolar/molar region of the right maxilla without any history of traumatic tooth extraction. The premolars were missing and an irregular fleshy lump was bulging from the sinus. The 1st molar tooth had high mobility with mesial tipping and its roots were included inside the tumor. In clinical examination no lymph node enlargement was identified. Both panoramic and three-dimensional computed tomography images revealed wide bone resorption with the perforation of the palatal bone and the destruction of lateral wall of the right maxillary sinus. The remaining two right molars were extracted and a biopsy was taken from the lump. Due to spontaneous perforation of the maxillary sinus, the preoperative diagnosis was thought to be ameloblastoma. The histological examination revealed the lesion to be CCOC. The patient, who had no metastases, underwent right hemi-maxillectomy, radiotherapy and chemotherapy. The case presented here indicates the importance of considering malignancy in cases of spontaneous oroantral perforation for early diagnosis and treatment.