A case of sclerosing odontogenic carcinoma of the mandible

Abstract

Sclerosing odontogenic carcinoma (SOC), a rare tumor first described in 2008, was incorporated into the World Health Organization (WHO) classification of odontogenic carcinomas in 2017. We present a case of SOC in the mandible. A 45-year-old female patient presented with pain in the right lower jaw and was referred to our hospital. The patient exhibited facial symmetry, with reduced sensitivity in the right lower lip and right side of the tongue. A smooth-surfaced soft mass (22 × 13 mm) was observed on the marginal gingiva surrounding first and second molars in the right mandible. A mass was identified in the region extending from the right mandibular first molar to the right mandibular ramus. CT imaging revealed cortical bone destruction on both the vestibular and lingual aspects in this region and a mass measuring 42 × 37 × 20 mm. SOC or odontogenic fibroma was suspected based on the biopsy findings. A right submandibular lymph node biopsy, segmental mandibular resection, and reconstruction using a free fibular flap were performed. Intraoperative pathological examination revealed no cervical lymph node metastasis, and neck dissection was not performed. Based on the resected specimen, a definitive diagnosis of SOC was established. 22 months post-surgery, no recurrence or metastasis has been observed.