Dentinogenic ghost cell tumor - a neoplastic variety of calcifying odontogenic cyst: case presentation and review

The calcifying odontogenic cyst (COC), also referred to as calcifying ghost cell odontogenic cyst (CGCOC) is a heterogeneous lesion existing either as cystic or solid variant. Due to the fact that all CGCOC lesions are not cystic, and the biological behavior is often not consistent with a cyst, there has always been a controversy as to whether COC is a cyst or a tumor. The dentinogenic ghost-cell tumor (DGCT), a solid variant of the COC, is an uncommon odontogenic neoplasm occurring predominantly in later life. Case report is followed by a concise review and disambiguation of controversial terminologies regarding nomenclature of COC. We report a case of 33-year-old female patient who presented with an insidious, steadily increasing swelling on the left side of her face since 8 months. Patient reported slight difficulty in eating because of reduced intraoral space and an obvious concern with facial disfigurement. There was no contributory dental or medical history. Intraorally, a hard, well defined, bicortical swelling was noted in left maxillary region with slight mobility of the associated teeth and normal appearing overlying mucosa. A provisional diagnosis of adenomatoid odontogenic tumor was made, and orthopantomogram, paranasal sinus radiograph and computed tomograpy scan of the face were acquired. A radiographic diagnosis of COC was made, which was subsequently confirmed on histopathology postenucleation of the tumor mass. COC has been seen to be of extensive diversity in its clinical and histopathological features as well as in its biological behavior. The present case of 33-year-old female was diagnosed as DGCT, a tumorous form of COC, due to its characteristic histological features; numerous ghost cells and dentinoid material.