The calcifying ghost cell odontogenic tumor – or the calcifying odontogenic cyst

Abstract

Abstract. The paper reports on two new cases of calcifying odontogenic cysts, and gives a survey of 50 cases reported in the literature. In one case the ultrastructure of the characteristic ghost cells was examined. Most of the cells were anuclear or contained pyknotic nuclei. The only organelles found were very thick electro‐dense fibrils of uniform size sharply defined against large empty spaces. Small needle‐like crystalloid structures were seen in most cells. The ghost cells lying free in the connective tissue or embedded in the osteiod material had either lost their plasma membranes entirely or only remmants of it could be found. Histologically there is a marked similarity between the published cases. The epithelium forming either cysts or islands shows a distinct basal layer of columnar cells. Above the basal layer the cells are often stellate. Ghost cells are observed. Scattered both in the epithelium and in the surrounding connective tissue. Outeoid or dentinoid material was observed close to the ghost cells in 14 of 36 cases. Calcified deposits have been described in the ghost cells in 26 out of 36 cases reported. The material demonstrates an almost equal sex distribution of the tumor, and an almost equal distribution between the anterior maxilla and mandible. Two‐thirds of the tumors were intra‐osseous, and one‐third were extra‐osseous. The tumor occurs in all age groups, with an increased incidence in the age group of 10–19 years. There is no similarity between the clinical features of this lesion and those of ameloblastoma and calcifying odontogenic tumor. The authors interpret the lesion as a tumor or hamartoma with a marked tendency for cystic degeneration. Therefore the designation calcifying ghost cell odontogenic tumor has been proposed.

A Case of Calcifying Odontogenic Cyst With Numerous Calcifications: Immunohistochemical Analysis

“…However, there is much discussion about the diverse histology of COC. In 1972, Fejerskov and Krogh used the term "calcifying ghost cell odontogenic tumor " 6) . Sauk reported that the osteoid or dentinoid in the COC is formed by true derivation development from the epithelium, and that COC should be considered a tumor-like disease rather than a cyst 18) .…”

Peripheral Calcifying Odontogenic Cyst: A Case Report and Review of the Literature

“…Peripheral dentinogenic ghost cell tumors were not included. To summarize the data, the review of cases was performed in the following manners: first, the data from reviews carried out in 1991 by Buchner et al [7] were used; to confirm the information, all works described by these authors between 1962 and 1991 [1,2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] were reviewed. Second, the papers from 1991 to 2010 [5,[22][23][24][25][26] were analyzed.…”

Calcifying odontogenic cyst case reports, variations, and tumorous potential.

“…Some investigators including FEJERSKOV et al [11], EDA [17] and LucAs [4] found that the disease occurred more frequently in the maxillary than the mandibular region, whereas FREEDMAN et al [7], ALTINI et al [18] and BAsKER [5] reported the disease to be of comparable incidence in both these rep-inns In our CPriPC the tylny;M was found to be more often affected with a ratio of 7 to 3 in Japan. But, the mandibular region in the foreign reports was 6 to 4.…”

“…Some of the features presented make its definition as a merely cystic lesion unwarrantable, e.g., epithelial induction and growth with clinical features such as root resorption [6], bone destruction [7] and recurrence [8,9]. These features have led some investigators to define the disease as a neoplastic lesion to be qualified by descriptive terms such as "Cystic calcifying odontogenic tumor" [7], "Dentinogenic ghost cell tumor" [10], "Calcifying ghost cell tumor" [11] and so on. Thus, there is no agreement as to the definition and nomenclature of the disease.…”