Therefore, PIOSCC must be considered in the differential diagnosis of malignant tumors of odontogenic epithelium, including ameloblastic carcinoma, clear cell odontogenic carcinoma, central mucoepidermoid carcinoma, odontogenic ghost cell carcinoma, and a malignant variant of
calcifying epithelial odontogenic tumor. Characteristics reminiscent of ameloblastoma, such as alveolar patterns and peripheral palisading of cells, may be exhibited in some PIOSCCs, but typical features of ameloblastic differentiation that would justify a diagnosis of ameloblastic carcinoma are lacking.