The calcifying ghost cell odontogenic tumor – or the calcifying odontogenic cyst

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Abstract

<jats:p><jats:bold>Abstract. </jats:bold> The paper reports on two new cases of calcifying odontogenic cysts, and gives a survey of 50 cases reported in the literature. In one case the ultrastructure of the characteristic ghost cells was examined. Most of the cells were anuclear or contained pyknotic nuclei. The only organelles found were very thick electro‐dense fibrils of uniform size sharply defined against large empty spaces. Small needle‐like crystalloid structures were seen in most cells. The ghost cells lying free in the connective tissue or embedded in the osteiod material had either lost their plasma membranes entirely or only remmants of it could be found. Histologically there is a marked similarity between the published cases. The epithelium forming either cysts or islands shows a distinct basal layer of columnar cells. Above the basal layer the cells are often stellate. Ghost cells are observed. Scattered both in the epithelium and in the surrounding connective tissue. Outeoid or dentinoid material was observed close to the ghost cells in 14 of 36 cases. Calcified deposits have been described in the ghost cells in 26 out of 36 cases reported. The material demonstrates an almost equal sex distribution of the tumor, and an almost equal distribution between the anterior maxilla and mandible. Two‐thirds of the tumors were intra‐osseous, and one‐third were extra‐osseous. The tumor occurs in all age groups, with an increased incidence in the age group of 10–19 years. There is no similarity between the clinical features of this lesion and those of ameloblastoma and calcifying odontogenic tumor.</jats:p><jats:p>The authors interpret the lesion as a tumor or hamartoma with a marked tendency for cystic degeneration. Therefore the designation calcifying ghost cell odontogenic tumor has been proposed.</jats:p>

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