Clear Cell Odontogenic Carcinoma of the Mandible Incidentally Detected During Routine Dental Examination: A Case Report With 8-Year Follow-up

Abstract

Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic epithelial tumor that primarily affects the mandible. Due to its nonspecific clinical and radiographic features, preoperative diagnosis is often difficult. We report an asymptomatic case of CCOC in an elderly woman in her eighties, in whom a mandibular radiolucent lesion was incidentally detected during routine dental examination. Imaging revealed a well-defined radiolucent lesion with lingual cortical bone perforation. Incisional biopsy suggested CCOC or a salivary gland tumor. Marginal mandibulectomy was performed, and histopathological examination demonstrated infiltrative nests of clear and polygonal epithelial cells containing abundant diastase-sensitive PAS-positive intracytoplasmic glycogen granules. Immunohistochemical staining was positive for cytokeratin (AE1/AE3) and p63, supporting the diagnosis of CCOC. No recurrence or metastasis has occurred during 8 years of follow-up. CCOC should be included in the differential diagnosis of asymptomatic mandibular radiolucent lesions, and long-term follow-up is required.

Keywords

• clear cell odotogenic carcinoma
• mandible
• case report

Rutin Diş Muayenesi Sırasında Tesadüfen Saptanan Mandibular Berrak Hücreli Odontojenik Karsinom: 8 Yıllık Takipli Bir Olgu Sunumu

Abstract

Berrak hücreli odontojenik karsinom (CCOC), esas olarak mandibulayı etkileyen nadir bir malign odontojenik epitelyal tümördür. Spesifik olmayan klinik ve radyografik özellikleri nedeniyle, preoperatif tanı çoğu zaman zordur. Rutin diş muayenesi sırasında mandibulada radyolüsent bir lezyonun tesadüfen saptandığı, seksenli yaşlarında yaşlı bir kadında asemptomatik CCOC olgusunu sunuyoruz. Görüntülemede, lingual kortikal kemik perforasyonu ile birlikte iyi sınırlı bir radyolüsent lezyon saptandı. İnsizyonel biyopsi sonucunda CCOC veya tükürük bezi tümörü düşünüldü. Marjinal mandibulektomi uygulandı ve histopatolojik incelemede, bol miktarda diastaza duyarlı PAS-pozitif intrasitoplazmik glikojen granülleri içeren berrak ve poligonal epitelyal hücrelerden oluşan infiltratif yuvalanmalar gösterildi. İmmünohistokimyasal boyamada sitokeratin (AE1/AE3) ve p63 pozitifliği saptanarak CCOC tanısı desteklendi. Sekiz yıllık takip süresince nüks veya metastaz gelişmedi. CCOC, asemptomatik mandibular radyolüsent lezyonların ayırıcı tanısında göz önünde bulundurulmalı ve uzun süreli takip yapılmalıdır.

Keywords

• berrak hűcreli odontojenik karsinom
• mandibula
• olgu sunumu

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