Abstract：
A dentinogenic ghost cell tumor (DGCT) is a rare benign odontogenic tumor that commonly shows characteristics of solid proliferation and has a relatively high risk of recurrence after surgical treatment. We herein report a case of a central DGCT that occurred in the maxilla and resulted in bone expansion. This study highlights new imaging findings (particularly magnetic resonance imaging) along with histopathological observations. In addition, we conducted a review of the existing literature on this rare tumor. A 37-year-old man developed swelling around the right cheek. A benign odontogenic tumor such as ameloblastoma was suspected based on the imaging examination findings (including bone expansion and the internal characteristics of the tumor) on panoramic imaging, computed tomography, and magnetic resonance imaging. The lesion was surgically excised from the right maxilla. Postoperative histopathological examination led to a definitive diagnosis of central DGCT. The tumor comprised epithelial neoplastic islands, resembling ameloblastoma, inside tight fibroconnective tissue; masses of ghost cells and formation of dentin were also observed. We had suspected that the minute high-density region around the molars on the imaging examinations represented alveolar bone change; however, it represented dentin formation. This led to difficulty diagnosing the lesion. Although DGCT may present characteristic findings on imaging examinations, its occurrence is infrequent, and in some cases, the findings may include the presence or absence of an impacted tooth without obvious calcification. The present case suggests that we should consider the possibility of an odontogenic tumor with calcification when high-density structures are observed inside the lesion.
摘要：
牙源性鬼细胞瘤（DGCT）是一种罕见的良性牙源性肿瘤，通常表现出固体增殖的特征，并且在手术治疗后复发的风险相对较高。我们在此报告一例发生在上颌骨并导致骨扩张的中央DGCT。这项研究突出了新的成像发现（特别是磁共振成像）以及组织病理学观察。此外,我们对这种罕见肿瘤的现有文献进行了综述。一名37岁的男子右脸颊周围出现肿胀。根据全景成像的影像学检查结果（包括骨扩张和肿瘤的内部特征），怀疑是良性牙源性肿瘤，例如成釉细胞瘤。计算机断层扫描,和磁共振成像。从右侧上颌骨手术切除病灶。术后组织病理学检查可明确诊断中央DGCT。肿瘤包括上皮性肿瘤岛，类似成釉细胞瘤，在紧密的纤维结缔组织内；还观察到大量的鬼细胞和牙本质的形成。我们怀疑影像学检查中磨牙周围的微小高密度区域代表牙槽骨改变；然而，它代表了牙本质的形成。这导致难以诊断病变。尽管DGCT可能在影像学检查中呈现特征性发现，它的发生很少，在某些情况下,这些发现可能包括有无阻生牙而无明显钙化。本病例表明，当在病变内部观察到高密度结构时，我们应该考虑牙源性肿瘤钙化的可能性。
