Radiographic Enigma: a case report of clear cell odontogenic neoplasm in the anterior mandible diagnosed by Cone Beam Computed Tomography

Prarthana Sudeep; Aravind Meena Shanmughan; Mahija Janardhanan; Indu PS

doi:10.17126/joralres.2026.007

Prarthana Sudeep Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India. http://orcid.org/0000-0003-3799-2851
Aravind Meena Shanmughan Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India. http://orcid.org/0000-0002-9733-0879
Mahija Janardhanan Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India. http://orcid.org/0000-0002-2155-4876
Indu PS Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India. http://orcid.org/0000-0002-8300-6840

DOI: https://doi.org/10.17126/joralres.2026.007

Keywords: Case report, Mandibular neoplasms, Odontogenic tumors, Cone-beam computed tomography, Diagnosis, differential, Mandible

Abstract

Introduction: Clear cell odontogenic carcinoma (CCOC) is a rare and aggressive odontogenic tumour, seldom involving the anterior mandible.
Case Report: This report presents an atypical case in a 38-year-old female, emphasizing the diagnostic challenges, the role of CBCT in detecting aggressive features, and the importance of considering CCOC in the differential diagnosis of anterior mandibular lesions. The patient presented with gingival swelling, and cone-beam computed tomography revealed a diffuse, irregular, expansile lesion with labial cortical perforation, thinning of the lingual cortex, and hyperdense foci. Periosteal bone formation was also noted anteriorly.
Results: These atypical features initially suggested alternative diagnoses, but histopathological evaluation confirmed CCOC.
This case reinforces the diagnostic challenges of CCOC and demonstrates the utility of radiographic evaluation for identifying aggressive features of rare mandibular tumours.

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