Sclerosing Odontogenic Carcinoma: A Review of a Challenging Entity in Malignant Odontogenic Classification With a Focus on Perineural Invasion and Cellular Proliferation

Authors

• Merva Soluk-Tekkesin, Ankara Üniversitesi
• Keith David Hunter, University of Liverpool
• Ronell Bologna-Molina, Universidad de la Republica
• Kelly Magliocca, Emory University School of Medicine
• Liam Robinson, University of Pretoria
• Akinyele Olumuyiwa Adisa, College of Medicine, University of Ibadan
• Jiang Li, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine
• Elizabeth Ann Bilodeau, University of Pittsburgh
• Haizal Mohd Hussaini, Faculty of Dentistry
• Madhu Shrestha, Texas A&M College of Dentistry
• Ricardo Santiago Gomez, Universidade Federal de Minas Gerais
• Willie van Heerden, University of Pretoria
• Wanninayake Mudiyanselage Tilakaratne, Universiti Malaya

Document Type

Review

Publication Date

1-1-2026

Abstract

Background: Sclerosing odontogenic carcinoma (SOC) is a rare intraosseous neoplasm defined by the World Health Organization as a locally aggressive tumor with “no metastatic potential”. Objective: This review provides a critical evaluation of the biological behavior, clinicopathologic features, and clinical management of SOC cases, with a particular focus on neural invasion and cellular proliferation scores. Methods: A comprehensive literature was performed using the Pubmed and Scopus databases to identify all published English-language reports of SOC. Results: The analysis of 22 reported cases revealed that SOC predominantly affects the mandible in middle-aged adults, typically presenting as a radiolucent lesion associated with cortical resorption. Histopathologically, perineural invasion was identified in 77.3% of cases and revealed a wide range of Ki-67 expression (1%–%30). Conclusion: This challenging entity exhibits a spectrum of malignant potential, and the current classification standard of “no metastatic potential” requires revision. In cases exhibiting diverse biological behaviors, the Ki-67 proliferation score can be used an ancillary marker for risk stratification; higher rates (e.g., > 10%–15%) may be associated with aggressive local invasion and metastatic events. Further molecular studies on aggressive “metastatic” cases are imperative to allow for identification of definitive markers that can establish SOC as a distinct entity and provide a rational basis for risk assessment and treatment.

Publication Title

Journal of Oral Pathology and Medicine

ISSN

09042512

DOI

10.1111/jop.70125

Recommended Citation

Soluk-Tekkesin, Merva; Hunter, Keith David; Bologna-Molina, Ronell; Magliocca, Kelly; Robinson, Liam; Adisa, Akinyele Olumuyiwa; Li, Jiang; Bilodeau, Elizabeth Ann; Hussaini, Haizal Mohd; Shrestha, Madhu; Gomez, Ricardo Santiago; van Heerden, Willie; and Tilakaratne, Wanninayake Mudiyanselage, "Sclerosing Odontogenic Carcinoma: A Review of a Challenging Entity in Malignant Odontogenic Classification With a Focus on Perineural Invasion and Cellular Proliferation" (2026). Research Publications (2026 to 2030). 378.
https://knova.um.edu.my/research_publications_2026_2030/378