Sclerosing odontogenic carcinoma: current diagnostic and management considerations concerning a most unusual neoplasm

Abstract

Sclerosing odontogenic carcinoma (SOC) is a primary intraosseous carcinoma of the jaws that has been listed as a separate entity for the first time in the latest version of the World Health Organization classification of Head and Neck Tumours (2017). The aim of this study was to analyse and interpret the existing literature on SOC in the context of a clinical case treated in the authors’ department. A systematic search of the PubMed database was performed in accordance with the PRISMA guidelines, yielding nine cases of SOC reported so far. In summary, characteristic clinical and radiological features of SOC include asymptomatic swelling, location predominantly in the mandible, tumour primarily lytic in appearance, presence of cortical bone destruction, and lack of metastatic spread. Due to the rarity of the disease, close collaboration between oral/maxillofacial surgeons and pathologists is crucial to avoid misdiagnosis. With complete excision, no recurrence of SOC should be expected.

Sclerosing odontogenic carcinoma (SOC) is defined as a primary intraosseous carcinoma of the jaws with a bland cytology, a markedly sclerotic stroma, and a locally aggressive and infiltrative growth pattern . Whether SOC should be regarded as a separate entity or as part of a morphological spectrum of other odontogenic carcinomas remains controversial . Nevertheless, in the latest version of the World Health Organization Classification of Head and Neck Tumours (2017), SOC has been introduced as an independent subtype.

SOC was first described by Landwehr and Allen in 1996 . Twelve years later, Koutlas et al. reported three cases of SOC , including the case reported by Landwehr and Allen. Histologically, SOC appears as single file thin cords, nests, and strands of epithelium in a densely sclerotic stroma . Differential diagnoses include metastatic carcinoma, primary intraosseous carcinoma, clear cell odontogenic carcinoma, and ameloblastic carcinoma , as well as desmoplastic ameloblastoma, intraosseous mucoepidermoid carcinoma, and (the epithelium-rich variant of) odontogenic fibroma .

The aim of this study was to analyse and interpret the existing literature on SOC with a focus on clinical, radiological, and histological features and therapeutic options. The results are discussed in the context of a recent clinical case.

Materials and methods

A literature search of the PubMed database was performed. The following medical subject heading (MeSH) terms were used: “odontogenic sclerotic carcinoma”, “sclerosing odontogenic carcinoma”, “sclerotic odontogenic carcinoma”.

In accordance with the PRISMA guidelines , all records identified as PubMed database entries were surveyed for duplicates. After removing duplicates, the abstracts of the remaining records were screened against the exclusion criteria (no case reported, not describing SOC). Subsequently, full-text articles were retrieved and assessed for eligibility. The references included in the full-text articles were reviewed for further case reports on SOC. Articles identified in the references search were retrieved and the full-texts assessed for eligibility. Finally, all records were analysed according to the aims of this study. The flow diagram of the literature search is given in Fig. 1 . Furthermore, a clinical case provided by the authors is reported.

Dec 14, 2017 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Sclerosing odontogenic carcinoma: current diagnostic and management considerations concerning a most unusual neoplasm

VIDEdental - Online dental courses

Get VIDEdental app for watching clinical videos