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Juxtaoral organ of Chievitz: A histopathological masquerade

CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2015; 36(03): 193

DOI: DOI: 10.4103/0971-5851.166762

Publication History

Article published online:
12 July 2021

© 2015. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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A 46-year-old female diagnosed with squamous cell carcinoma (SCC) of right buccal mucosa [Figure 1] underwent wide surgical excision of the tumor, and histopathological clearance of resection margins was requested for further management. Tissue harvested from posterior resection margin [arrow, Figure 1] histologically revealed well circumscribed epithelial sprouts present within the loose connective tissue stroma rich in nerves [Figure 2]. These were parenchymal rests of nonkeratinized squamous cells delineated by a basement membrane with few cells showing paler cytoplasm and clear cell-like features [inset, Figure 2]. Based on the anatomic location and the histological features, these structures were recognized as juxtaoral organ of Chievitz (JOOC), and the margin was cleared from tumor invasion. JOOC is a normal permanent anatomical structure located within the soft tissue overlying the angle of the mandible in the buccotemporal space. JOOC is known to mimic various pathologies such as a perineural invasion by SCC, adenoid cystic, mucoepidermoid, and thyroid carcinomas.[]

Fig. 1 Ulceroproliferative lesion in the right buccal mucosa extending from corner of the mouth to the retromolar region (arrow showing, area of posterior resection margin of the tumor)

Fig. 2 Well circumscribed epithelial sprouts present within the loose connective tissue stroma representative of juxtaoral organs of Chievetz (H and E, original magnification ×100). Inset: Cells showing paler cytoplasm and clear cell like features (H and E, original magnification ×1000)

Awareness and knowledge about JOOC and similar physiological structures are indispensable among surgical pathologists to avoid misdiagnosis and unnecessary extensive surgical procedures.


REFERENCE

1. Pantanowitz L, Balogh K. Significance of the Juxtaoral organ (of Chievitz) Head Neck. 2003;25:400–5. [PubMed[]

Fig. 1 Ulceroproliferative lesion in the right buccal mucosa extending from corner of the mouth to the retromolar region (arrow showing, area of posterior resection margin of the tumor)

Fig. 2 Well circumscribed epithelial sprouts present within the loose connective tissue stroma representative of juxtaoral organs of Chievetz (H and E, original magnification ×100). Inset: Cells showing paler cytoplasm and clear cell like features (H and E, original magnification ×1000)

REFERENCE

1. Pantanowitz L, Balogh K. Significance of the Juxtaoral organ (of Chievitz) Head Neck. 2003;25:400–5. [PubMed[]