Thank you for the opportunity to respond to the letter regarding the article by S un et al. on the treatment of the dentinogenic ghost cell tumor (DGCT). The DGCT is an extremely rare odontogenic tumor. According to Buchner’s research of 215 cases of intraosseous calcifying odontogenic cysts, he found that the calcifying odontogenic cysts (COCs) account for 1-2% of all odontogenic tumors, and only 2–14% of COCs are solid tumors. These solid tumors were considered to be DGCTs. Thus based on even a large sample size of patients that may have DGCTs, it remains a very rare finding. Therefore, even though our 10 year experience of a sample size was small (N=7), the findings are of significance. Of the 7 patients, 5 had recurrences. All of these 5 patients had been initially treated conservatively using only curettage. Of the 2 patients that had been treated using aggressive local resection, no recurrences were found. So in our experiences it appears that intraosseous DGCTs should be treated similar to recommendations for ameloblastoma. We feel that enucleation is the appropriate treatment for most calcifying cystic odontogenic tumor (CCOT), but not for the DGCT.

Likewise, Kasahara et al. reviewed 11 patients with DGCT in the literature, and found that the recurrent rate was 36%, and recommended that the treatment of DGCT should be similar to the ameloblastoma, and the patients should remain in long-term follow-up.

We understand and appreciate the concerns raised in the letter to Editor but stand behind our findings, clinical results and conclusion. However, we agree additional studies with larger population size are needed to definitively determine if aggressive resection is the best treatment of the DGCT.

Sincerely,

Mr. Enyi Tang