Sclerosing odontogenic carcinoma – what we know so far

Sclerosing odontogenic carcinoma (SOC) was described in 2008 and is recognised as a malignant odontogenic tumour in the World Health Organisation classification of head and neck tumours. Nine cases have been reported including six in the mandible and three in the maxilla. After initial controversy over whether SOC was a variant of an odontogenic tumour or a separate entity, it is now established as a distinct entity with an infiltrative and invasive pattern but is usually a diagnosis of exclusion as other odontogenic neoplasms should be ruled out first. They are low‐grade tumours most commonly exhibiting perineural and soft tissue invasion, but distant metastases have not been reported. Treatment varies from radical resection, neck dissection and radiotherapy to enucleation or curettage with no adjuvant treatment. There has been one reported recurrence, occurring eight months after curettage, which was treated with segmental mandibular resection, but no incidences of disease‐related mortality. We report a case of SOC initially treated as an odontogenic fibroma by enucleation. Once the diagnosis of SOC was confirmed, local excision without neck dissection or radiotherapy was undertaken. The patient remains disease‐free, suggesting local excision might be sufficient treatment. Treatment standardisation cannot be possible without more reported cases.