Verdeja Raúl, Stauffer Edouard, Lombardi Tommaso
Department of Surgery, Service of Maxillofacial and Oral Surgery, University Hospital and Faculty of Medicine, 1205 Geneva, Switzerland.
Private Pathology Institute (Promed), 1700 Fribourg, Switzerland.
Diagnostics (Basel). 2022 Apr 18;12(4):1019. doi: 10.3390/diagnostics12041019.
Clear cell odontogenic carcinoma (CCOC) is a rare, aggressive epithelial neoplasm of the jaw first described in 1985 by Hansen and classified as an odontogenic malignant tumor in the 2005 WHO classification. To date, only 117 cases have been reported in the literature written in English. In this paper, we report the atypical presentation of a pericoronal localized tumor in the right mandibular wisdom tooth discovered during a routine radiologic examination. The patient, a 44-year-old healthy female, was referred by her general dental practitioner for examination of temporomandibular dysfunction and recurrent myofascial pain. Anamnesis and clinical examination did not suggest tumoral disease. The osteolytic lesion was removed, and histological examination revealed a clear cell odontogenic tumor (CCOT) of the right posterior lower jaw. Segmental lower jaw resection was performed, and a free iliac crest bone transplant was fixed with mandibular reconstruction plate. No cervical neck dissection was needed. A five-year follow-up examination shows excellent local and systemic recovery and no sign of tumor recurrence. The patient still suffers from bruxism and myofascial related pain, which are treated conservatively with a Michigan splint and physiotherapy. Based on this additional case, we review the literature and discuss the challenging diagnostic aspects, the unusual clinical presentation, and the treatment of CCOC.
透明细胞牙源性癌（CCOC）是一种罕见的、侵袭性的颌骨上皮性肿瘤，1985年由汉森首次描述，并在2005年世界卫生组织分类中被归类为牙源性恶性肿瘤。迄今为止，英文文献中仅报道了117例。在本文中，我们报告了一例在常规放射学检查中发现的右下颌智齿冠周局部肿瘤的非典型表现。患者为一名44岁健康女性，由其普通牙科医生转诊，以检查颞下颌关节功能障碍和复发性肌筋膜疼痛。病史和临床检查未提示肿瘤性疾病。切除溶骨性病变，组织学检查显示右下颌后下部为透明细胞牙源性肿瘤（CCOT）。进行了下颌骨节段性切除，并用下颌重建钢板固定了游离髂嵴骨移植。无需进行颈部淋巴结清扫。五年的随访检查显示局部和全身恢复良好，无肿瘤复发迹象。患者仍患有磨牙症和肌筋膜相关疼痛，采用密歇根矫治器和物理治疗进行保守治疗。基于这一额外病例，我们回顾了文献并讨论了透明细胞牙源性癌具有挑战性的诊断方面、不寻常的临床表现及治疗方法。
