Ghost cell odontogenic carcinoma (GCOC) is an exceedingly rare malignant tumor on the spectrum of already uncommon odontogenic or dentinogenic tumors. We describe here the case of metastatic GCOC in a patient with a history of recurrent dentinogenic ghost cell tumor of the mandible, now presenting with bilateral pleural effusions. We will discuss typical histopathologic and histochemical features of GCOC, along with results of genomic testing and their role in directing therapy.
