文摘
An 18-year-old female reported painful swelling in the left maxillary region 4 months after the extraction of tooth #15. Because incisional biopsy suggested ameloblastoma with clear-cell changes, segmental resection was performed. The microscopic examination of the excised tissue revealed histomorphologic diversity, with features of typical calcifying ghost cell odontogenic tumor (CGCOT) and a significant clear-cell component constituting more than 50% of the tumor mass without any features of malignancy. Clear cells were periodic acid–Schiff (PAS) positive and mucicarmine negative. CK19 was strongly positive in the solid tumor islands and variably positive in clear cells. A definitive diagnosis of CGCOT with predominance of clear cells was confirmed. Because both squamous metaplasia and clear-cell components were present in the ameloblastic follicles independent of each other, the presence of abundant calcifications favored the diagnosis of CGCOT with a clear-cell component over that of an ameloblastoma with clear-cell changes. The importance of identifying the histomorphologic features of the 2 entities, ameloblastoma and CGCOT, is highlighted. This appears to be the second case reported in the literature, to the best of our knowledge.