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. 2025 Apr;20(2):1355-1357.
doi: 10.1016/j.jds.2024.12.012. Epub 2024 Dec 30.

Successful treatment of mandibular central dentinogenic ghost cell tumor with en bloc resection and dental rehabilitation: A case report

Chen-Chieh Hsu  1 , Meng-Ling Chiang  1   2   3   4 , Jyh-Kwei Chen  1   2   3   5   6
Affiliations

Successful treatment of mandibular central dentinogenic ghost cell tumor with en bloc resection and dental rehabilitation: A case report

Chen-Chieh Hsu et al. J Dent Sci. 2025 Apr.
No abstract available

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Conflict of interest statement

The authors have no conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
Photographs of a 47-year-old Taiwanese male patient with a right mandibular central dentinogenic ghost cell tumor, depicting clinical findings, historical and current radiographic findings, histopathologic findings, and radiographic along with the clinical follow-up findings. (A) Intraoral examination showing a rubbery, dome-shaped soft tissue bulging mass about 10 × 10 × 5 mm in size over the right mandibular buccal vestibule at the premolar area; the surface was red with a minor ulceration. The mandibular right canine (tooth 43) was buccally displaced; the mandibular right first premolar (tooth 44) was non-vital by the electric pulp testing. (B) Panoramic view of the cone-beam computed tomography (CBCT) showing a heterogeneous, irregular radiopaque aggregate with no demarcated border between the roots of the teeth 42 and 43, in a background of partially ill-defined, irregular radiolucent lesion, spanning from the root apex of the tooth 46 to the root apex of the tooth 41 (pointed out by the white arrowheads), from near the marginal bone of the tooth 44 to near the lower border of the mandible. Roots of the teeth 42 and 43 were displaced to the side of the radiopaque aggregate. There was no sign of inferior border expansion or thinning of the mandible, nor was there bulging of the right inferior alveolar canal. With the span of the tumor considered, we estimated that the en bloc resection by segmental mandibulectomy with the lateral borders encapsulating at least 10 mm of the uninvolved bone (marked by the white dashed lines) would be needed. (C) Axial sections of the CBCT from the level of middle third of the root to the root apex of the tooth 43, taken during the second visit were displayed. They showed the lesion hypodense to the bone marrow growing up to 25.9 × 29.0 × 11.0 mm in 7 years, spanning laterally to the root apex of the tooth 46 and the root apex of the tooth 31 (pointed out by the white arrowheads), while the radiopaque lesion remained the same size. (D) Sagittal sections of the CBCT from the right premolar area to the middle plane were displayed. They showed loss of trabecular bone and buccal cortical plate from the teeth 42 to 45, from the cervical area of the teeth 44 to near the lower border of the mandible. The intrabony part of the lesion has an ill-defined margin, while the perforated part of the lesion was seen separated from the muscle layer by the periosteum (pointed out by the white arrowheads), which likely contributed to its rubbery texture. This further suggested that the en bloc resection by the marginal mandibulectomy including the buccal muscle layer had the chance to fully remove the tumor. (E) Axial sections of head and neck CT taken 7 years prior to the first visit to our OPD, from the similar levels as that of Fig. 1C were displayed. They showed an ill-defined 8.6 × 5.8 × 8.0 mm radiopaque lesion between the teeth 42, 43 and 44 with an irregular 16.6 × 22.4 × 8.6 mm lesion hypodense to the bone marrow surrounding the radiopaque lesion (pointed out by the white arrowheads). The radiolucent lesion spanned from the tooth 45 to the tooth 42, and no further below the root apex of the tooth 43. No overt bony expansion or buccal cortical plate perforation was noted. Compared to the current CBCT image, such lesion had the chance of complete removal through marginal mandibulectomy with far less structure removed. (F) Photomicrographs of specimen showing a network of ameloblastomatous epithelium, with microcysts, infiltrating the peripheral connective tissue (pointed out by the black triangles). The huge segment of dentinoid matrix can also be seen (pointed out by the black arrowheads). (hematoxylin and eosin stain; original magnification; 25 × ) (G) Photomicrographs of specimen showing groups of ghost cell (marked by the black asterisks) within the network of the ameloblastomatous epithelium. (hematoxylin and eosin stain; original magnification; 25 × ) (H) Panoramic radiographs taken at the one-year postoperative follow-up showing the well-reconstructed mandible. Surgical management in this case was the en bloc resection of the mandible with 10 mm free bony margin and 5 mm soft tissue margin, leaving at least one uninvolved anatomic barrier on the tumor specimen. The mandible was reconstructed with the free fibular flap; patient also received the full mouth rehabilitation with dental implant-supported overdenture. There were good osseointegration between the mandible and the graft, with no sign of recurrence. (I) Intraoral examination at the one-year postoperative follow-up showing a well-reconstructed mandible with the fully functional dental implant-supported overdenture.
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References

    1. de Arruda J.A.A., Monteiro J.L.G.C., Abreu L.G., et al. Calcifying odontogenic cyst, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma: a systematic review. J Oral Pathol Med. 2018;47:721–730. - PubMed
    1. Pinheiro T.N., de Souza A.P.F., Bacchi C.E., Consolaro A. Dentinogenic ghost cell tumor: a bibliometric review of literature. J Oral Dis Marker. 2019;3:9–17.
    1. Singhaniya S., Barpande S., Bhavthankar J. Dentinogenic ghost cell tumor. J Oral Maxillofac Pathol. 2009;13:97. - PMC - PubMed
    1. Sun G., Huang X., Hu Q., Yang X., Tang E. The diagnosis and treatment of dentinogenic ghost cell tumor. Int J Oral Maxillofac Surg. 2009;38:1179–1183. - PubMed
    1. Carlson E.R., Marx R.E. The ameloblastoma: primary, curative surgical management. J Oral Maxillofac Surg. 2006;64:484–494. - PubMed

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