A nineteen years old male patient showed a cystic lesion in left maxillary canine to premolar area (#23-#25). This lesion was asymptomatic, and found during his routine radiological check in local clinic. In the radiological observation the cystic lesion showed round radiolucent image containing many calcified bodies which were usually small but irregular in shape, expanding tumorously and resulted in the displacement of canine and second premolar in the absence of first premolar. The lesion was surgically enucleated, and a cystic fibrous tissue containing abnormal teeth was removed and examined pathologically. With the histological observation of tumorous odontogenic epithelium including many ghost cells, which were closely associated with abortive teeth, the lesion was finally diagnosed as CCOT associated with complex odontoma. The ghost cells of CCOT was strongly positive for β-catenin, GADD45, and LC3, and slightly positive for MMP-9, while they were rarely positive for BCL2, Wnt1, HSP-70, and p38. Therefore, it was presumed that the ghost cells of CCOT might undergo dormant cell state through altered cytodifferentiation stimulated by severe growth arrest, DNA damage signaling, and abundant autophage formation.

• 이상신(강릉원주대학교 치과대학 병리학교실 및 구강과학연구소, Department of Pathology, College of Dentistry, Gangneung-Wonju National University and Institution of Oral Science, Gangneung) | Sang Shin Lee
• 이석근(강릉원주대학교 치과대학 병리학교실 및 구강과학연구소, Department of Pathology, College of Dentistry, Gangneung-Wonju National University and Institution of Oral Science, Gangneung) | Suk Keun Lee Correspondence
• 김연숙(청주대학교 보건의료대학 치위생학과, Department of Dental Hygiene, College of Health Sciences, Cheongju University, Cheongju) | Yeon Sook Kim