Clear cell odontogenic carcinoma: report of a case and analysis of the literature

BACKGROUND: Clear cell odontogenic carcinoma (CCOC), which has been described within the past 2 decades, is a rare odontogenic tumor that tends to occur in the mandible of older adults, with a predilection for women. It is potentially aggressive and capable of multiple local recurrences and locoregional and distant metastases. OBJECTIVES: To report the clinicopathologic findings and follow-up of a case of CCOC and to review the literature. DESIGN: Case report and literature review. MAIN OUTCOME MEASUREMENTS: Findings from histologic analysis, immunohistochemistry, and electron microscopy. RESULTS: An 81-year-old woman experienced 3 locoregional recurrences within 21 months of initial therapy. She is presently disease free, 4.5 years after initial resection, having received multiple resections and adjuvant radiotherapy. CONCLUSIONS: The diagnosis of CCOC must be considered in the differential diagnosis of jaw tumors with a clear cell component. For these tumors, resection with negative margins is the treatment of choice because more conservative surgery (eg, curettage) inevitably results in recurrence and/or metastasis. Adjuvant radiotherapy is a rational option for tumors that have eroded cortex.