CLEAR CELL ODONTOGENIC CARCINOMA OF THE MANDIBLE: CLINICOPATHOLOGICAL FEATURES IN A RARE CASE

Laís Inês Silva Cardoso; Ingrid Araújo Oliveira Consolaro; Alberto Consolaro; Carlos Gabriel Valério da Silva; Palena Araujo Pinto; Thalita Santana

doi:10.5327/2525-5711.485

Authors

Laís Inês Silva Cardoso School of Dentistry, University of São Paulo https://orcid.org/0000-0002-6478-5439
Ingrid Araújo Oliveira Consolaro School of Dentistry, University of São Paulo https://orcid.org/0000-0002-4663-6405
Alberto Consolaro School of Dentistry, University of São Paulo https://orcid.org/0000-0002-5902-5646
Carlos Gabriel Valério da Silva CEUMA University, São Luís, MA, Brazil https://orcid.org/0009-0004-3464-8902
Palena Araujo Pinto CEUMA University, São Luís, MA, Brazil https://orcid.org/0000-0002-5729-3495
Thalita Santana CEUMA University, São Luís, MA, Brazil https://orcid.org/0000-0002-2172-9031

DOI:

https://doi.org/10.5327/2525-5711.485

Keywords:

Clear Cell Odontogenic Carcinoma, Odontogenic Tumors, Mandible, Immunohistochemistry, Differential Diagnosis

Abstract

Clear cell odontogenic carcinoma (CCOC) is a rare malignant odontogenic neoplasm with aggressive biological behavior and considerable diagnostic complexity due to its overlapping features with other clear cell tumors of the jaws. This report describes a case of CCOC arising in the anterior mandible of a 39-year-old woman presenting with progressive, painless swelling. Radiographic and computed tomography examinations demonstrated an expansive intraosseous lesion with predominantly radiolucent characteristics and focal hyperdense areas. Histopathological analysis revealed nests and islands of polygonal epithelial cells with abundant clear cytoplasm embedded in a densely hyalinized stroma, associated with focal eosinophilic differentiation and infiltrative growth. Immunohistochemical evaluation showed strong positivity for p40, p63, and CK7, supporting odontogenic epithelial differentiation, while SOX10 negativity contributed to the exclusion of salivary gland clear cell neoplasms. Based on the integrated clinicopathological and immunohistochemical findings, a definitive diagnosis of CCOC was established. The patient underwent surgical resection with tumor-free margins and remained free of recurrence or metastasis after one year of follow-up. This case highlights the importance of a multidisciplinary diagnostic approach for distinguishing CCOC from other odontogenic and metastatic clear cell lesions, thereby enabling appropriate surgical management and long-term oncologic surveillance.

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