Dentinogenic ghost cell tumor invading the maxillary sinus: A rare case report with a review of the literature

Abstract

Dentinogenic ghost cell tumor (DGCT) is a rare, locally aggressive odontogenic neoplasm. This report presents the case of an 80-year-old female with DGCT involving the left maxilla and maxillary sinus. Orthopantomography radiography revealed a well-defined radiopaque lesion in the left posterior maxilla, while Waters’ view demonstrated an irregular radiopaque mass with mixed radiolucent and radiopaque features in the maxillary sinus. Advanced imaging, including CT, confirmed the mass extending into the maxillary sinus and adjacent structures. Histopathological examination of the biopsy indicated DGCT, characterized by ameloblastoma-like epithelium, ghost cells, and dentinoid formation. The patient underwent partial resection of the left maxilla. Immunohistochemistry revealed positive staining for β-catenin, bcl-2, and p63, with a 15 % Ki-67 expression. At 26 months postoperatively, the patient showed no signs of recurrence. A review of the literature identified 13 cases of DGCT with maxillary sinus involvement since 2000, revealing a recurrence rate of approximately 60 % and a potential risk of malignant transformation into ghost cell odontogenic carcinoma. Recurrence was commonly observed in cases treated conservatively, likely due to initial misdiagnosis as a calcifying odontogenic cyst based on incisional biopsy findings, along with challenges related to maxillary sinus involvement. Given the aggressive nature of DGCT, we advocate for surgical resection with long-term follow-up to reduce the risk of recurrence and malignant transformation.