Resolving the Diagnostic Dilemma of Clear Cell Odontogenic Carcinoma Using Special Stains: A Case Report

Abstract

Aim:To resolve the diagnostic dilemma of clear cell odontogenic carcinoma (CCOCa) using various special stains. Background: Clear cell odontogenic carcinoma is a rare malignant odontogenic tumor with a female predilection, occurring predominantly in the mandible. It is an aggressive tumor with frequent recurrences (55%) and high metastatic potential (31%). Case description: Herein, we report a case of an unusual extensive mandibular tumor mass in 49-year-old male patient who posed diagnostic challenges due to similar microscopic features of oral squamous cell carcinoma (OSCC), clear cell mucoepidermoid carcinoma (CCMEC), hyalinizing clear cell carcinoma (CCC), epithelial myoepithelial carcinoma (EMC), clear cell variant of calcifying epithelial odontogenic tumor (CCCEOT), and clear cell odontogenic ghost cell tumor (CCOGCT). Conclusion: The use of appropriate special stains like mucicarmine, Van Gieson, and Periodic Acid Schiff with and without diastase paved the way toward confirmatory diagnosis. Clinical significance: Good knowledge and right practice of various special staining techniques in histopathology provides a rapid and reproducible result with better diagnosis.