An Extensive Calcifying Epithelial Odontogenic Tumor: Multidisciplinary Diagnostic Approach

A calcifying epithelial odontogenic tumor (CEOT), also known as a Pindborg tumor, is a rare benign odontogenic neoplasm with variable biological behavior and potential for locally aggressive growth. Its clinical, radiological, and histopathological features may mimic malignancy, creating diagnostic challenges. We report the subsequent clinical course and definitive management of an extensive CEOT in a 34-year-old woman whose lesion had previously been reported as CEOT. Approximately 8 years later, she presented with persistent nonhealing ulcer of the right buccal mucosa and progressive swelling of the right posterior mandible. An incisional biopsy performed at another institution was diagnosed as oral squamous cell carcinoma (OSCC). The patient was subsequently referred to specialized cancer hospital for further evaluation. Repeat histopathological examination revealed anastomosing islands and well-defined nests of polyhedral tumor cells with eosinophilic cytoplasm and centrally located round nuclei. Basophilic calcifications and homogenous eosinophilic material were also observed, supporting the diagnosis of CEOT. Considering the aggressive clinical presentation and extensive involvement, segmental resection of the mandible followed by reconstruction was performed. The case emphasizes the importance of careful clinicoradiographic and histopathological correlation in establishing an accurate diagnosis and guiding appropriate management of CEOT.