Dentinogenic Ghost Cell Tumor Research Articles

Distant metastasis of intraosseous dentinogenic ghost cell tumour to the donor site of a bone graft

A dentinogenic ghost cell tumour (DGCT) is an extremely rare odontogenic tumour which is considered as a solid, neoplastic variant of calcifying odontogenic cyst. Intraosseous DGCTs are more aggressive than extraosseous DGCTs and have a high propensity for local recurrence. This report describes a case of a diagnosis of recurrent DGCT at the primary site and a distant donor site. A 25-year-old female patient visited a dental hospital for a complaint of facial swelling for the previous month. Incisional biopsy was performed and the specimen was diagnosed as DGCT. Partial mandibulectomy for tumour resection and iliac bone graft was performed. 2 years later, the tumour recurred on the mandible and iliac bone. The recurrent lesion on the donor site was diagnosed as metastasized DGCT. This report highlights the possibility of distant metastasis occurring at a graft donor site.

Pyogenic granuloma mimicking peripheral dentinogenic ghost‐cell tumour recurrence: case report and meta‐analytic literature update

AbstractPeripheral (extraosseous) dentinogenic ghost‐cell tumours are extremely rare neoplasms, representing less than 1% of all odontogenic tumours. Only 28 cases (including the present report) are described in literature: the majority of patients (89%) are over 40 years of age (mean: 59.1 ± 20.5 years) and 63% are male. Seventy‐three per cent are located in the mandible, and anterior jaw regions are most commonly affected (74%). Erosion of the underlying bone can be observed in 53% radiographically. The present case report describes a recurrent swelling after excisional biopsy of a peripheral dentinogenic ghost‐cell tumour in the anterior maxilla of a 78‐year‐old male patient mimicking tumour recurrence. Histopathological examination of the second biopsy, however, revealed no evidence of ghost‐cell tumour recurrence but development of a pyogenic granuloma. In contrast to central dentinogenic ghost‐cell tumours, there is no evidence of recurrence of peripheral dentinogenic ghost‐cell tumours in literature to date.

상아질성 유령세포종양: 증례보고와 문헌고찰

Dentinogenic ghost cell tumor (DGCT) is a rare epithelial odontogenic neoplasm, representing 1.9% to 2.1% of all odontogenic tumors. It is the neoplastic counterpart of the calcifying odontogenic cyst (COC), and characteristic islands of odontogenic epithelical cells contain numerous ghost cells and dysplastic dentin, and also have many common histological features with ameloblastoma. The 2005 World Health Organization (WHO) Classification of Odontogenic Tumours re-named this entity as calcifying cystic odontogenic tumor (CCOT) and defined the clinico-pathological features of the ghost cell odontogenic tumours, CCOT, DGCT and ghost cell odontogenic carcinoma (GCOC). We report a rare case of central DGCT in the posterior maxilla of a 31-year-old female with literature review, for the emphasis of Oral and Maxillofacial surgeon's role.

Periferal Dentinojenik Hayalet Hücreli Tümör: Klinik, Histopatolojik ve Radyolojik Bulguların Değerlendirilmesi

The dentinogenic ghost cell tumor is a rare solid variant of the calcifying odontogenic cyst. A 77-year-old man presented with a gingival mass on the alveolar crest mucosa of canine to first premolar of the right mandibular region. After clinical and radiological examination, the prediagnosis was peripheral ossifying fibroma. An incisional biopsy was performed, and the specimen was submitted for histopathologic evaluation. The lesion was characterized histopatholocially by ameloblastoma-like odontogenic epithelial proliferation, presence of ghost cells and dentinoid material. It was finally diagnosed as peripheral dentinogenic ghost cell tumor after excision with a margin of sound bone. In this report, a rare new case is described and the relevant literature is briefly reviewed.

Peripheral dentinogenic ghost cell tumor

Dentinogenic ghost cell tumors (DGCT) are uncommon lesions mainly with rare peripheral types. This report presents a case of peripheral DGCT on the left side of the mandibular alveolar ridge of a heavy smoker, a 68-year-old man, with main presenting feature as a mild pain. Submandibular lymphadenopathy and radiological saucerization were evident. Differential diagnosis included fibroma, neurofibroma, peripheral ameloblastoma, peripheral odontogenic fibroma, and peripheral giant cell granuloma. Histologically, ameloblastoma-like epithelial elements were seen in association with grouped ghost cells. Proliferating polyhedral cells and stellate reticulum-like cells with various densities were spread over a wide range of the field. The lesion was curetted and after 2 years of follow up, it did not recur.

Expression of PCNA, p53 and Ki-67 in dentinogenic ghost cell tumor and calcifying cystic odontogenic tumors

Expression of PCNA, p53 and Ki-67 in dentinogenic ghost cell tumor and calcifying cystic odontogenic tumors

Dentinogenic ghost cell tumour of mandible: Case report

Alti aydir gingivada kitlesi olan 67 yasindaki erkek hasta aspirasyon sitolojisi ve eksizyonel biyopsi ile degerlendirildi. Sitolojik bulgularda benign odontojenik keratositleri animsatan dejenere benign epitelyal hucreler goruldu. Fakat eksizyonel biyopsi, dentinojenik ghost hucreli tumor ozelliklerinden olan aberant keratinizasyon, ghost hucreleri ve displastik dentin gorulen odontejenik epitel acisindan oldukca belirgindi. Malignite belirtisi yoktu. Kitlenin lokal rezeksiyonundan sonraki 6 aylik donemde herhangi bir komplikasyon veya rekurrens izlenmedi.

Ghost cell odontogenic carcinoma arising in the background of a benign calcifying cystic odontogenic tumor of the mandible

Ghost cell odontogenic carcinoma (GCOC) is a rare malignant variant of odontogenic tumor with ghost cells; only 29 cases are documented. Our patient was a 68-year-old man with a painless, well-defined, radiolucent swelling of the mandibular gingiva in the right incisor-to-molar region. It was diagnosed as a benign calcifying cystic odontogenic tumor (CCOT) on fenestration biopsy. Eighteen years later, he returned with swelling in the same area. The lesion was excised, diagnosed as GCOC, and considered a secondary malignant manifestation of the benign CCOT. No adjuvant chemotherapy or radiotherapy was administered, and his postoperative course was uneventful for 48 months, with no recurrence or distant metastasis. Among the 30 reported cases of GCOC, the mean age at diagnosis was 40.3 years, 22 (73%) involved the maxilla. Twelve (40%) were secondary malignant manifestations of benign CCOTs or dentinogenic ghost cell tumors. Five patients died of recurrence or distant metastasis.

上顎に生じた象牙質形成性幻影細胞腫の1例

象牙質形成性幻影細胞腫（Dentinogenic ghost cell tumor：以下DGCT）は以前には石灰化歯原性嚢胞の充実型と呼ばれていたが，新WHO分類で嚢胞状の形態を示す石灰化嚢胞性歯原性腫瘍（calcifying cystic odontogenic tumor：以下CCOT）と充実性に増殖するDGCTの2型に分けられた。今回右側上顎に発症したDGCTの1例を経験した。組織学的な特徴として上皮組織内に多数の幻影細胞の出現や石灰化物を認め，象牙質の形成を特徴とするものはDGCTとされるため，組織生検を行う場合には画像所見で石灰化物が認められた場合はこれを含むように組織生検を行う必要がある。DGCTは外科的切除が一般的であるが再発を繰り返しやすいとされており，今回の症例でも摘出後に再発が認められた。摘出に際しては切除範囲を考慮し十分な安全域を確保することが重要であり，場合により顎骨離断等の処置が必要であることが考えられた。腫瘍切除後の経過観察は重要であり，CTやMRI等による画像検査が有効であった。

Peripheral Dentinogenic Ghost Cell Tumor

Peripheral dentinogenic ghost cell tumor is a rare tumor with only 24 cases previously described in the English literature. The majority of cases have been reported to occur in the anterior part of the jaws. A case occurring in posterior (molar region) of the mandible in a 75-year-old edentulous woman is reported. The patient presented with a nodular swelling in the left mandible that showed erosion (saucerization) of the underlying bone radiographically. On microscopy, the tumor showed mainly solid epithelial islands resembling ameloblastoma in fibrous connective tissue. The islands were associated with ghost cells and dysplastic dentin. This report includes the clinical, radiographic, and microscopic features of the patient, in addition to the review of the English literature on the tumor.

The treatment of dentinogenic ghost cell tumour

The treatment of dentinogenic ghost cell tumour

The treatment of dentinogenic ghost cell tumor

The treatment of dentinogenic ghost cell tumor

Dentinogenic Ghost Cell Tumor of the Peripheral Variant Mimicking Epulis

Dentinogenic ghost cell tumor (DGCT) is an uncommon locally invasive odontogenic tumor regarded by many as a variant of calcifying odontogenic cyst. The peripheral variant of this clinical rarity appears as a well-circumscribed mass mimicking a nonspecific gingival enlargement. Microscopic appearance of odontogenic epithelium admixed with focal areas of dentinoid formation and sheets of ghost cells giving the definitive diagnosis of dentinogenic ghost cell tumor imply that microscopic examination is compulsory for any gingival mass. Van Gieson histochemical stain further confirmed the nature of dentinoid-like material. A complete workup of a case of peripheral dentinogenic ghost cell tumor is presented in this paper and the current concept as well as the appraisal of literature is presented.

Peripheral dentinogenic ghost cell tumor: a case report and review of the literature

Dentinogenic ghost cell tumor (DGCT) is a rare neoplasm, representing 1.9% to 2.1% of all odontogenic tumors. Few cases of DGCT have been reported and only 11 show no bone involvement. A rare case of peripheral DGCT is reported, located in the anterior mandible of a 45-year-old man. The patient presented a slow painless growth in the canine region of an edentulous mandible. Radiographically, no bone involvement was registered. The lesion was enucleated and microscopically characterized by islands of epithelial cells showing ameloblastomalike features in fibrous tissue. Dysplasic dentin and ghost cells were frequently observed. Areas showing a connection between tumor cells and the overlying mucosa were also identified. Immunohistochemical analysis demonstrated positivity for pan-cytokeratin, cytokeratin-14, and 2 neural markers. Denditric cells (Langerhans cells and melanocytes) were identified inside tumoral islands. A rare case of peripheral DGCT is reported, with immunohistochemical analysis and a review of the English literature.

The diagnosis and treatment of dentinogenic ghost cell tumor

The purpose of this study is to assess the diagnosis, treatment and prognosis of the dentinogenic ghost cell tumor (DGCT). This is a retrospective study of patients with DGCT who underwent one or multiple surgical interventions during the 10-year period from 1997 to 2007. Seven patients with DGCT were identified under the WHO 2005 classification guidelines. The lesions were located in the maxilla in 4 patients and in the mandible in 3 patients. Five patients experienced recurrences following conservative surgery. They were all treated with aggressive local resection. Two patients had no conservative surgery but aggressive local resection. After 7-105 months' follow-up, no recurrences were found in any of the patients. Intraosseous DGCT should be treated by resection with an adequate safety margin, of at least 0.5 cm, as recommended for ameloblastoma. Patients with a DGCT should remain in long-term follow-up.

The diagnosis and treatment of dentinogenic ghost cell tumour

Background and Objectives: The purpose of this study was to assess the diagnosis, treatment and prognosis of the dentinogenic ghost cell tumours.

Ghost cell odontogenic carcinoma transformed from a dentinogenic ghost cell tumor of maxilla after multiple recurrences

Dentinogenic ghost cell tumor (DGCT), also referred to as odontogenic ghost cell tumor, is a rare tumor classified as a neoplastic variant of calcifying odontogenic cyst (COC). Ghost cell odontogenic carcinoma (GCOC) is the especially rare malignant counterpart of DGCT and COC. The case of a middle-aged male with a maxillary DGCT which transformed to GCOC after 5 recurrences during a 21-year period is presented. When the diagnosis of GCOC (first identified as malignant after 17-year recurrence) was made, the tumor cells showed more obvious atypia, necrosis, and numerous mitoses, and interestingly the ghost cell was hard to find and even disappeared. The significances in pathologic diagnosis and clinical treatment are discussed.

Dentinogenic ghost cell tumor

Dentinogenic ghost cell tumor (DGCT) is a rare tumorous form of calcifying odontogenic cyst and only a small number of cases have been described. It is a locally invasive neoplasm that is characterized by ameloblastoma-like epithelial islands, ghost cells and dentinoid. The present report describes a case of a 21-year-old male with a tumor in the posterior region of the mandible, showing features of DGCT.

Roles of matrix metalloproteinases and tissue specific inhibitors of metalloproteinases in dentinogenic ghost cell tumor and ghost cell odontogenic carcinoma

To investigate the roles of matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMP) in dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC). The expressions of MMP-2, MMP-9, MMP-14, TIMP-1 and TIMP-2 were examined in 15 DGCT cases and 9 GCOC cases by immunohistochemistry. Their mRNA expression in one DGCT case and one GCOC case were investigated by RT-PCT.MMP-2 and MMP-9 protein activities in the two cases were analyzed by gelatin zymography. MMP-9 and TIMP-1 expressions elevated greatly in GCOC, and there was a significant difference (P < 0.05) in TIMP-1 expression between GCOC and DGCT.Pro-MMP-9, MMP-9 activated form, pro-MMP-2, and MMP-2 activated forms were detected in the GCOC case, while pro-MMP-9 and MMP-9 activated form were very faint in the DGCT case. The mRNA level of MMP-9 elevated obviously in the GCOC case, which was similar to that of TIMP-1. The elevated expression of MMP-9 and TIMP-1 may influence the behaviour of GCOC.

The expression of NF-κB, Ki-67 and MMP-9 in CCOT, DGCT and GCOC

Calcifying odontogenic cysts (COCs) represent a group of rare odontogenic lesions with a diversity of clinicopathological and behavioral features. According to the WHO classification of head and neck tumors in 2005, COC has been divided into calcifying cystic odontogenic tumor (CCOT), dentinogenic ghost cell tumor (DGCT) and ghost cell odontogenic carcinoma (GCOC). With few reports available on its immunohistochemical profile, this study investigated the histopathological features and the expression of nuclear factor kappaB (NF-kappaB), Ki-67 and matrix metalloproteinase-9 (MMP-9) in CCOT, DGCT and GCOC. According to the WHO classification of head and neck tumors in 2005, 26 cases of the so-called COC were diagnosed as CCOT (n=14), DGCT (n=7) and GCOC (n=5), respectively. The specimens of 26 COCs and 10 classic ameloblastomas (as control group) were examined by immunohistochemistry using anti-NF-kappaB p65, anti-Ki-67 and anti-MMP-9 antibodies and by in situ hybridization(ISH)using anti-MMP-9 mRNA probes. Immunohistochemical reactivity for NF-kappaB was mainly detected in the cytoplasm of tumor cells, and nuclear reactivity was only seen in few tumor cells in COC and classic ameloblastomas. Rate of nuclear staining was less than 1%. The expression of Ki-67 in GCOC was significantly higher than those in CCOT (p<0.001), DGCT and ameloblastoma (p<0.005). In COCs and ameloblastomas, expression of MMP-9 mRNA and protein was detected in tumor cells as well as in stromal cells. The positive staining for MMP-9 protein was detected in stromal cells of all GCOC cases and was significantly stronger than those in CCOT and DGCT groups (p<0.05). NF-kappaB may minimally affect the progression and local invasiveness of CCOT, DGCT and GCOC. GCOC show significantly higher proliferative activity than CCOT and DGCT. MMP-9 in stroma is associated with invasive ability of the CCOT, DGCT and GCOC.