Malignant transformation of calcifying epithelial odontogenic tumour with solitary pulmonary metastasis |
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| Affiliation: | 1. Department of Oral and Maxillofacial Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK;2. Cellular Pathology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK;1. Service de Chirurgie Maxillo-faciale et Chirurgie Plastique, Hôpital Necker – Enfants Malades, Assistance Publique – Hôpitaux de Paris, Université de Paris, Paris, France;2. Service de Chirurgie Maxillo-faciale et Stomatologie, Hôpital Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Sorbonne Université, Paris, France;3. Service d’Anatomopathologie, Hôpital Cochin – Port-Royal, Assistance Publique – Hôpitaux de Paris, Université de Paris, Paris, France;4. Service d’Anatomopathologie, Hôpital Necker – Enfants Malades, Assistance Publique – Hôpitaux de Paris, Université de Paris, Paris, France;5. Service d’Anatomopathologie, Hôpital La Timone, APHM, Marseille, France;1. Maxillofacial Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy;2. Neurosurgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy;3. Simulation Centre, General Surgery Department, Academic Hospital of Udine, Department of Medicine, University of Udine, Udine, Italy;1. Department of Oral and Maxillofacial Surgery, MKA Kennemer & Meer, Haarlem, the Netherlands;2. Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, the Netherlands;3. Department of Oral and Maxillofacial Surgery, BovenIJ Hospital, Amsterdam, the Netherlands;4. Orthodontisten Haarlem, Haarlem, the Netherlands;5. Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center, AMC Location, Amsterdam, the Netherlands;1. Oral and Maxillofacial Surgery, South Wales, UK;2. Department of Plastic and Reconstructive Surgery, North Bristol NHS Trust, Bristol, UK;3. Department of Surgery, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;4. Department of Plastic and Reconstructive Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia;5. Oral Surgery Department, Guy’s Hospital, Guy’s and St Thomas’ Foundation Trust, London, UK;6. Department of Oral and Maxillofacial Surgery, University College London Hospitals NHS Foundation Trust, London, UK |
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| Abstract: | This report describes the management of a case of calcifying epithelial odontogenic tumour (CEOT) that underwent malignant transformation and metastasized to the lung. The solitary pulmonary metastasis was discovered incidentally on computed tomography (CT) imaging of the neck. It appears that only one previous case with proven pulmonary metastasis has been reported in the literature, which involved multiple pulmonary deposits managed with platinum chemotherapy. The long-term prognosis of metastatic CEOT is therefore unknown. In the case presented here, the patient was managed successfully with surgery alone. There is often diagnostic uncertainty because histological features of benign, recurrent, and malignant CEOT are not dissimilar. Ki-67 immunohistochemistry is helpful, as higher levels are more indicative of malignancy. We consider that in cases of suspected recurrent and malignant CEOT, CT imaging of the thorax and abdomen as part of follow-up may identify metastases early, resulting in earlier treatment, an improved prognosis, and reduced morbidity and mortality. |
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| Keywords: | odontogenic tumor jaw neoplasms mandibular neoplasms neoplasm metastasis immunohistochemistry |
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