{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:11:52Z","timestamp":1785161512041,"version":"3.55.0"},"reference-count":9,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,5]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>We report the case of a fit and well pregnant patient in her 20s who presented with a progressively expansile swelling of the left maxilla. Despite extraction of the presumed causative tooth, the lesion continued to enlarge, extending to the orbital floor and resulting in infraorbital nerve paraesthesia. Post-partum radiological imaging demonstrated a markedly displaced upper left third molar associated with a large lytic lesion obliterating the left maxillary sinus. Differential diagnoses included a dentigerous cyst, ameloblastoma or malignancy.<\/jats:p>\n                  <jats:p>Surgical enucleation of the lesion with removal of the ectopic tooth was performed under general anaesthesia. Radiological, histological, microbiological and cytological findings demonstrated overlapping features of dentinogenic ghost cell tumour and calcifying odontogenic cyst (COC). Given the differing biological behaviour and follow-up requirements, multidisciplinary discussion was essential. Multidisciplinary consensus favoured a diagnosis of COC. The patient recovered well and remains under close long-term follow-up.<\/jats:p>","DOI":"10.1136\/bcr-2025-271808","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:32Z","timestamp":1785158432000},"page":"e271808","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Challenging diagnosis of a large maxillary lesion: the multi-disciplinary approach"],"prefix":"10.1136","volume":"19","author":[{"given":"Eloise","family":"Turner","sequence":"first","affiliation":[{"name":"Maxillofacial Surgery, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Wade","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0300-8054","authenticated-orcid":false,"given":"Panayotis E","family":"Dais","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divyakumari","family":"Keshani","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072706201477000_19.7.e271808.1","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1111\/jop.12727","article-title":"Calcifying odontogenic cyst, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma: A systematic review","volume":"47","author":"de Arruda","year":"2018","journal-title":"J Oral Pathol Med"},{"key":"2026072706201477000_19.7.e271808.2","unstructured":"El-Naggar AK , Chan JKC , Grandis JR , eds. WHO classification of head and neck tumours. 5th edn. Lyon: International Agency for Research on Cancer, 2022."},{"key":"2026072706201477000_19.7.e271808.3","doi-asserted-by":"crossref","DOI":"10.1259\/dmfr.20200586","article-title":"Calcifying odontogenic cysts: A 20-year retrospective clinical and radiological review","volume":"50","author":"Nel","year":"2021","journal-title":"Dentomaxillofac Radiol"},{"key":"2026072706201477000_19.7.e271808.4","doi-asserted-by":"crossref","first-page":"192","DOI":"10.5306\/wjco.v10.i4.192","article-title":"Dentinogenic ghost cell tumor: A case report","volume":"10","author":"Patankar","year":"2019","journal-title":"World J Clin Oncol"},{"key":"2026072706201477000_19.7.e271808.5","doi-asserted-by":"crossref","first-page":"S142","DOI":"10.4103\/0975-7406.155864","article-title":"Ghost cell lesions","volume":"7","author":"Rajesh","year":"2015","journal-title":"J Pharm Bioallied Sci"},{"key":"2026072706201477000_19.7.e271808.6","doi-asserted-by":"crossref","first-page":"227","DOI":"10.3109\/00016358109162284","article-title":"Calcifying Odontogenic Cyst","volume":"39","author":"Pr\u00e6torius","year":"1981","journal-title":"Acta Odontol Scand"},{"key":"2026072706201477000_19.7.e271808.7","doi-asserted-by":"crossref","first-page":"100484","DOI":"10.1016\/j.modpat.2024.100484","article-title":"Calcifying Odontogenic Cyst Demonstrates Recurrent WNT Pathway Mutations and So-Called Adenoid Ameloblastoma-Like Histology: Evidence Supporting Its Classification as a Neoplasm","volume":"37","author":"Oh","year":"2024","journal-title":"Mod Pathol"},{"key":"2026072706201477000_19.7.e271808.8","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/jomfp.JOMFP_95_15","article-title":"Disorganized histomorphology: Dentinogenic ghost cell tumor","volume":"21","author":"Walia","year":"2017","journal-title":"J Oral Maxillofac Pathol"},{"key":"2026072706201477000_19.7.e271808.9","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.tripleo.2006.09.005","article-title":"Analysis of ghost cells in calcifying cystic odontogenic tumors by confocal laser scanning microscopy","volume":"104","author":"Lucchese","year":"2007","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271808","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:20:34Z","timestamp":1785158434000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":9,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,27]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2025-271808"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271808","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}