The clinicopathological study of a huge clear cell odontogenic carcinoma with partial transformation into a squamous cell.

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Malignant tumor consisting of elk, r. cells is often seen in the kidney and several other organs. This tumor, however, rarely occurs in oral and, maxillofacial regions. We recently experienced a huge clear cell carcinoma in a 79-year-old female, which putatively originated in the mandible, and o expansile into the right maxilla. zygoma, temporal bone, orbital, and partially into the cranium. Lymphnode (LN) metastasis was observed in the right submandibular LN. Histopathologically, the tumor was primarily composed of large sheets and islands of uniform vacuolated and clear cells separated by a mature fibrous connetive tissue. The tumor contained no glandular epithelial cells or myoepithelial cells. PAS positive and diastase digestable granules were observed in a small number of tumor cells. Immunohistochemical examination revealed that the tumor cells focally showed positive reaction to keratin (KT) and epithelial membrane antigen (EMA), but completely negative for actin, S-100, vimentin, and myosin. Ultrastructurally, the tumor cells were characterized by the presence of abundant cytoplasm and lack of intracellular organelles. Tonofilaments and desmosomes were, however, occasionally observed. From all of these findings, it is considered that the tumor cell may be derived from the odontogenic epithelium and mimick to clear cell odontogenic tumor. More interestingly, it was found that the tumor partially showed squamous cell differentiation after chemotherapy and immunotherapy. It is likely that the clear cell tumor may transform into squamous cell during differentiation process or vice versa, or the tumor may initially consist of two different kinds of tumor cells. The histogenesis of the tumor and its potential possiblility to differentiate into squamous epithelium are discussed.
社団法人日本口腔外科学会の論文

The clinicopathological study of a huge clear cell odontogenic carcinoma with partial transformation into a squamous cell.

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