A Peripheral Dentinogenic Ghost Cell Tumor With Immunohistochemical Investigations and a Literature Review–Based Clinicopathological Comparison Between Peripheral and Central Variants

The aim of the study was to present a peripheral dentinogenic ghost cell tumor (DGCT) and to describe clinicopathological differences between peripheral and central variants of the tumor using a selected literature review. The case report is based on a swelling present on the alveolar ridge of a 74-year-old edentulous denture wearer. The lesion was diagnosed as a peripheral DGCT after excluding the presence of a central lesion. Immunohistochemical investigations revealed similar cytokeratin expression pattern, with CK14 and MNF116 positivity in both the tumor and the surrounding surface epithelium. However, in contrast, CK19 expression was restricted to less than 5% of the tumor cells. A clinicopathological comparison was compiled using 30 cases of peripheral DGCTs (including the present lesion) and 16 cases of central DGCTs published over a period of 40 years. Accordingly, peripheral lesions were more often found in elderly denture wearers, in relation to mandibular gingiva and alveolar mucosa. None of the lesions had recurred after excision. In contrast, majority of the central lesions were common in younger individuals and showed a striking male predilection. It occurred equally on both jaws, while approximately 50% of the lesions gave rise to recurrences. In conclusion, similar cytokeratin expression in both the tumor and surface epithelium can be used to support oral surface epithelial origin, while CK14 positivity confirms the odontogenic derivation of the peripheral DGCT described in the report. In contrast to central DGCT, the peripheral DGCT is a distinct lesion with characteristic clinicopathological profile and nonaggressive behavior.