|LETTER TO EDITOR
|Year : 2014 | Volume
| Issue : 4 | Page : 293-294
Terminology ambiguity related to calcifying cystic odontogenic tumor and need for its universalisation
Kanu Jain1, Monica Mehendiratta2, Shweta Rehani1, Madhumani Kumra1
1 Department of Oral Pathology and Microbiology, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
2 Department of Oral Pathology and Microbiology, Inderprastha Dental College, Sahibabad, Ghaziabad, Uttar Pradesh, India
|Date of Web Publication||16-Oct-2014|
Department of Oral Pathology and Microbiology, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Jain K, Mehendiratta M, Rehani S, Kumra M. Terminology ambiguity related to calcifying cystic odontogenic tumor and need for its universalisation. CHRISMED J Health Res 2014;1:293-4
|How to cite this URL:|
Jain K, Mehendiratta M, Rehani S, Kumra M. Terminology ambiguity related to calcifying cystic odontogenic tumor and need for its universalisation. CHRISMED J Health Res [serial online] 2014 [cited 2021 Apr 11];1:293-4. Available from: https://www.cjhr.org/text.asp?2014/1/4/293/143010
Due to diverse clinicopathologic features and neoplastic potential of this lesion, various terminologies have been given. It was first described as calcifying odontogenic cyst (COC) by Gorlin et al. in 1962.  World Health Organization classified it under category of odontogenic tumors and renamed it from COC to CCOT in 2005, reflecting its neoplastic nature.  Different classifications of this lesion by various authors have only added to further confusion rather than enlightening. It is a rare lesion and accounts for only 2% of odontogenic tumors.  We also faced diagnostic dilemma when a 46-year-old male reported to our department with a large swelling of left posterior mandible since 4 months. After history and clinical examination, a provisional diagnosis of ameloblastoma was given and incisional biopsy was advised. Histopathological examination of hematoxylin- and eosin-stained sections showed presence of epithelium of variable thickness lining a cystic lumen along with proliferation of epithelial cells in solid islands. The basal layer was composed of cuboidal to columnar ameloblast-like cells with overlying loosely arranged stellate reticulum-like cells. Numerous ghost cells as epithelial cells devoid of nuclei but retained basic cell outline were also seen. Certain areas of calcification within sheets of ghost cells in epithelial lining as well as in solid islands were also appreciable [Figure 1]. Variable amount of hyalinized eosionophilic dentinoid material [Figure 2] and islands of odontogenic epithelium in the connective tissue were also evident [Figure 3]. Based on these findings, there was a diagnostic confusion that whether to give its final diagnosis as COC or calcifying cystic odontogenic tumor (CCOT). It often occurs in association with or contains areas histologically similar to a variety of odontogenic tumors, such as complex and compound odntoma, ameloblastoma, ameloblastic fibroma, ameloblastic fibro-odontoma, odontoameloblastoma, calcifying epithelial odontogenic tumor and adenomatoid odontogenic tumor.  Clinically, it may resemble different lesions, but only histopathologically a definitive diagnosis of this lesion can be established. Although many authors state that classifications remain only an academic exercise, it definitely has significance in treatment planning. Emphasis should, therefore, be laid on a universally accepted classification. 
|Figure 1: Photomicrograph showing (a) epithelial lining of variable thickness (black arrow) lining a cystic lumen (red arrow) along with proliferation in solid islands (blue arrow). (H & E Staining, 10×) (b) basal layer is composed of cuboidal to columnar ameloblast-like cells (blue arrow) with overlying loosely arranged stellate reticulum-like cells (black arrow) along with numerous ghost cells, which appear as epithelial cells devoid of nuclei but retained basic cell outline (red arrow). (H & E Staining, 40×)|
Click here to view
|Figure 2: Photomicrograph showing (a) areas of calcifi cations (red arrows) lying within sheets of ghost cells (blue arrows). (H & E Staining, 10×) (b) Variable amount of hyalinized eosionophilic dentinoid material (magenta arrow) (H & E Staining, 40×)|
Click here to view
|Figure 3: Photomicrograph showing (a and b) Islands of odontogenic epithelium in the connective tissue (H & E Staining, 10×). (c) an island with a cyst formation (red arrow) having epithelial lining similar to that of calcifying odontogenic cyst (H & E Staining, 10×)|
Click here to view
| References|| |
Gorlin RJ, Pindborg JJ, Odont, Clausen FP, Vickers RA. The calcifying odontogenic cyst-A possible analogue of the cutaneous calcifying epithelioma of Malherbe. An analysis of fifteen cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1962;15:1235-43.
Thinakaran M, Sivakumar P, Ramalingam S, Jeddy N, Balaguhan S. Calcifying ghost cell odontogenic cyst: A review on terminologies and classifications. J Oral Maxillofac Pathol 2012;16:450-3.
Iida S, Fukuda Y, Ueda T, Aikawa T, Arizpe JE, Okura M. Calcifying odontogenic cyst: Radiologic findings in 11 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:356-62.
Hirshberg A, Kaplan I, Buchner A. Calcifying odontogenic cyst associated with an odontome: A possible separate entity odonto-calcifying odontogenic cyst. J Oral Maxillofac Surg 1994;52:555-8.
Sonawane K, Singaraju M, Gupta I, Singaraju S. Histopathologic diversity of Gorlin's cyst: A study of four cases and review of literature. J Contemp Dent Pract 2011;12:392-7.
[Figure 1], [Figure 2], [Figure 3]