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1/4. Epithelial odontogenic ghost cell tumour of the mandibular gingiva.

    The epithelial odontogenic ghost cell tumour (EOGCT) is considered as a solid 'neoplastic' variant of the calcifying odontogenic cyst and is an uncommon lesion for which various names have been proposed over the years. We describe here an extraosseous case occurring on the edentulous mandibular gingiva in the right bicuspid area of a 70-year-old woman. The lesion was a painless nodule that appeared clinically as a hyperplastic mass, which was considered to be of reactive nature. Radiographic examination showed a localised resorption of the underlying mandibular bone. The tumour was excised; there was no recurrence at a 2-year follow-up examination.
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2/4. Calcifying odontogenic cyst. Report of two cases.

    Calcifying odontogenic cyst(COC) is an uncommon developmental odontogenic cyst and was first described by Gorlin in 1962. It is considered as extremely rare and accounts for only 1% of the jaw cysts reported. Here, we present two cases of which one occurred in a 32 year old female with a swelling in the lower anterior region crossing the midline and another in a 29 year old male with a swelling in the upper anterior region without crossing the midline. The radiograph revealed a well circumscribed radiolucency in the first case and with some specks of opacities in the second case. It was not associated with any missing or impacted tooth. Histopathological examination was done with hematoxylin and Eosin and in addition it was studied immunohistochemically for cytokeratin. The Classical histological features of lining epithelium in the form of cords, presence of ghost cells and some amount of dentinoid tissue were seen. The nature of COC is controversial. Here we have discussed the controversies regarding COC as well as the various proposed classifications for this lesion. Based on the histopathological findings, the diagnosis was confirmed as calcifying odontogenic cyst. These cases are presented here for its rarity.
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3/4. Ameloblastomatous calcifying odontogenic cyst: a rare histologic variant.

    Calcifying odontogenic cyst (COC) is an uncommon developmental odontogenic cyst first described by Gorlin in 1962. It is considered as extremely rare and accounts for only 1% of jaw cysts reported. Because of its diverse histopathology, there has always been confusion about its nature as a cyst, neoplasm or hamartoma. Several subclassifications have been proposed. Here, we present a case of calcifying odontogenic cyst with ameloblastic proliferation - an extremely rare histologic variant. The classical histologic features of the lining epithelium in the form of cords and presence of characteristic ghost cells were seen along with ameloblastomatous proliferations. Ameloblastomatous COC microscopically resembles unicystic ameloblastoma except for the ghost cells and calcifications within the proliferative epithelium. The nature of the COC is controversial. The case is presented here for its rarity, and difference between ameloblastomatous COC and ameloblastoma ex COC has been emphasized.
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4/4. Features of odontogenesis and expression of cytokeratins and tenascin-C in three cases of extraosseous and intraosseous calcifying odontogenic cyst.

    To characterize further the nature of calcifying odontogenic cyst (COC), we studied histologically and immunohistochemically an extraosseous and two intraosseous lesions. The extraosseous COC was in continuity with the stratified squamous epithelium of the alveolar mucosa. Immunostaining with monoclonal antibodies showed reactivity of both low- and high-molecular-weight cytokeratins, the degree of coexpression decreasing with the increasing morphological diversity of the cyst/tumour epithelium. Staining for the matrix glycoprotein tenascin-C was seen not only in the connective tissue, where its distribution patterns corresponded to the stage of hard tissue formation, but also in epithelial elements. The staining patterns were analogous to those described during normal tooth formation. Both the morphological characteristics and expression patterns of the various cytokeratin types and tenascin-C implied that COC represents a pathological counterpart of normal odontogenesis. In the case of the extraosseous COC, the correspondence could be traced back to early stages of tooth development.
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