Clear cell odontogenic carcinoma: report of 7 new cases and systematic review of the current knowledge

Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Oct;120(4):483-96. doi: 10.1016/j.oooo.2015.06.005. Epub 2015 Jun 15.

Abstract

Objective: The goal of this study is to describe 7 cases of clear cell odontogenic carcinoma among a Brazilian population and compare these data with a systematic review of the English-language literature.

Study design: Descriptive statististics were used to compare the clinicopathologic data gathered retrospectively with those compiled from a review. Tumor sections were immunostained for Ki-67, p16, p53, and cytokeratins (CKs) 7, 8, 14, 18, and 19. Log-rank tests were performed for survival analysis.

Results: Most cases occurred in the posterior mandible (5/7, 71.4%), and recurrence was diagnosed in all treated patients. Metastatic disease occurred in 2 patients (28.6%). Tumors were focally positive for CKs 7, 8, 14, and 18 and diffusely positive for CK19, p53, and p16. The mean number of Ki-67-positive cells was 35.2 cells/high-power field. Our systematic review provided evidence that tumor size (P = .046), histologic pattern (P = .034), regional metastasis (P = .001), distant metastasis (P = .001), and local recurrence (P = .05) were of significant prognostic value.

Conclusions: This study has contributed to improved characterization of clear cell odontogenic carcinoma, which is an aggressive odontogenic malignant neoplasm diagnosed mainly in the posterior mandible of middle-aged women and typically at an advanced stage. Radical surgical procedures remain the gold standard treatment.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adenocarcinoma, Clear Cell / epidemiology
  • Adenocarcinoma, Clear Cell / pathology*
  • Adenocarcinoma, Clear Cell / therapy
  • Adult
  • Biomarkers, Tumor / metabolism
  • Brazil / epidemiology
  • Diagnostic Imaging
  • Female
  • Humans
  • Immunohistochemistry
  • Jaw Neoplasms / epidemiology
  • Jaw Neoplasms / pathology*
  • Jaw Neoplasms / therapy
  • Male
  • Middle Aged
  • Odontogenic Tumors / epidemiology
  • Odontogenic Tumors / pathology*
  • Odontogenic Tumors / therapy
  • Prognosis

Substances

  • Biomarkers, Tumor