Pindborg tumor: A diagnostic challenge – report of a series of benign and malignant cases

Calcifying epithelial odontogenic tumor (CEOT), a benign, infrequent, odontogenic epithelial neoplasm, is mostly intraosseous, with occasional peripheral presentations. Although rare, the malignant transformation potential of CEOT has been reported. Herein, we elucidate four CEOT cases, involving female subjects, with emphasis on relevant clinical-radiological-histopathological and immunohistochemical diagnostic features. The CEOT cases presented here showed diverse clinical, radiological and histopathological spectrum, with one of the cases showing pronounced features of malignancy.IHC staining showed marked p53 positivity whereas Ki67 expression was less in the presented malignant case of this series. Differentiation between extremely benign, locally aggressive CEOTs and its malignant counterparts remain an enigma. IHC staining is instrumental in depicting malignant nature of CEOT. Scientific elucidation regarding more instances of malignant or recurrent variants of CEOTs is needed, to clearly understand their biology, aggression and behavior, through advanced molecular assays.