Clear cell variant of calcifying epithelial odontogenic tumor of maxilla: Report of a rare case
A 36-year-old Indian woman reported to our department with painless, slow growing swelling of right upper jaw and loss of upper teeth due to mobility. Intra oral examination revealed solitary swelling in right posterior maxillary region with missing posteriors. The swelling was about 3 × 2 cm with normal color, intact mucosa and indentations of opposing tooth []. The mass was firm on palpation with slightly more expansion towards the palatal side. OPG showed 3 × 3.5 cm mixed radiolucent-radiopaque lesion in the posterior maxilla with impacted teeth. Radiographically “driven snow” appearance was appreciable []. Computed tomography (CT) revealed radiolucent-radiopaque mass in the right maxilla invading the cortex []. The lesion extended to posterior maxilla and obliterated the right nasal cavity.\nAn incisional biopsy was taken from the lesion. The specimen was subjected to histopathological examination. Hematoxylin and Eosin stained sections showed fibrous connective tissue stroma with islands of polyhedral epithelial cells containing nuclei of varying form and size. Extracellular eosinophilic amyloid like material was found containing concentric calcifications in the form of Liesegang rings []. Few scattered cells were found with clear vacuolated cytoplasm (clear cells). No cellular atypia or mitotic figures seen. The features were suggestive of CCEOT.\nConsidering the age of the patient, esthetic concern and benign nature of CEOT, curettage of the lesion along with the associated tooth was performed under general anesthesia (GA).\nPatient reported back after 10 months complaining of nasal obstruction and tearing. CT scan confirmed recurrence in the posterior maxilla []. Intranasal biopsy was performed, revealed clear cells in the stroma of CEOT confirming the diagnosis of clear cell CEOT []. Subtotal maxillectomy with Weber Fergusson approach was done. Six weeks postoperatively, an obturator was given. No recurrence was found on 2 years follow-up.