Mimics in Surgical Pathology
Dr. Sunil Lakani
Dr. Salam Al-Sam
Case 6 -
Juxtaoral Organ Of Chievitz- A Diagnostic Pitfall
Dr. Michal Michal
Sikl's Department of Pathology
Laboratore Spec. Diagnostiky Medical Faculty Hospital
Alej Svobody 80, 304 60
PILSEN, Czech Republic
The lesion was excised from an 80 year old woman in
perimandibular soft tissues because of staging for the salivary gland tumor.
Histologically one can see small lobules of entirely benign nests of squamous cells in association
with twigs of peripheral nerves. MIB1 antibody reacted entirely negatively.
Case 6 - Figure 1
Diagnosis: Juxtaoral organ of Chievitz
Juxtaoral organ of Chievitz is one of the most treacherous pitfalls in the surgical pathology of the
head and neck tumors. It has remained an enigmatic structure since the time the lesion was originally
described by a Dutch anatomist in 1885, while studying the development of salivary glands .
This enigmatic structure had been given various names such as orbital
buccopharyngeal tract ,
buccotemporal organ 
and juxtaoral organ
Theories relating to its embryonic origin are as diverse as the suggested names fior this structure .
Juxtaoral organ of Chievitz may be quite a frequent finding in humans when meticulous exploration of
the area at the angle of the mandible near the insertion of the pterigomandibular raphe is made . Tschen and Fechner found the juxtaoral organ of Chievitz in 14 out of 25
consecutive autopsies in adults who did not have carcinoma or other lesion of the oral mucosa . The squamous cell nests of the juxtaoral organ of Chievitz can form
luminization of the epithelial nests . The main surgical pathological
significance lies in the fact that the squamous epithelial nests in the juxtaoral organ of Chievitz lie
in the vicinity of a peripheral nerve and that pathologist unwary of these structures might mistakenly
call them a squamous cell carcinoma with perineurial spread. This mistake is particularly threatening in
the patients operated for the primary squamous cell carcinoma of the oral cavity. The lack of mitoses
and especially the knowledge to existence of juxtaoral organ of Chievitz is the best way to avoid such
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