Recurrent Dentinogenic Ghost Cell Tumor: A Case Report

Patient: Male, 42-year-old Final Diagnosis: Dentinogenic ghost cell tumor Symptoms: Swelling • recurrent pain Medication: — Clinical Procedure: Segmental maxillectomy Specialty: Dentistry • Pathology • Surgery OBJECTIVE: Rare disease BACKGROUND: Dentinogenic ghost cell tumor (DGCT) is a rare, locally invasive odontogenic neoplasm, considered as a solid variant of the calcifying odontogenic cyst (COC). DGCT accounts for only 2% to 14% of all COCs and less than 0.5% of all odontogenic tumors. It is characterized by an ameloblastomatous odontogenic epithelium and the presence of ghost cells and dentinoid material. CASE REPORT: A 42-year-old male patient presented to the clinic with recurrent pain and swelling in the left maxilla. The patient had a similar presentation 3 years before, which had been managed by excisional biopsy and was misdiagnosed as unicystic ameloblastoma. Examination revealed a mild swelling in the left cheek with boney expansion on the posterior area of the left maxilla, with mobility in adjacent teeth. Radiographic evaluation revealed a large, well-demarcated radiolucent lesion with a sclerotic border involving the left maxilla and associated with root resorption in the adjacent teeth. An incisional biopsy was performed, and a diagnosis of DGCT was made. Segmental maxillectomy with safe margins was conducted, considering the aggressiveness of this pathological entity. The defect was reconstructed using the buccal fat pad. Histopathology examination confirmed the diagnosis of DGCT, which was characterized by ameloblastomatous odontogenic epithelium, dentinoid material, and ghost cells. One month follow-up revealed good healing of the surgical site. The patient was scheduled for regular follow-up. CONCLUSIONS: This case reports the aggressiveness and high recurrence rates of DGCT. It is recommended to treat DGCT aggressively with safe margins and a long-term follow-up.