Clear Cell Adenocarcinoma of the Base of the Tongue: A Case Report and Review of the Literature

Abstract

Clear cell adenocarcinoma is an extremely rare tumor of the head and neck region. We report a case of a 75-yearold Caucasian woman with a 10-day history of hemoptysis but with no pain or other signifi cant symptoms. A head and neck computed tomography scan with contrast medium showed an irregular, soft -tissue-like, irregularly enhanced lesion of the base of the tongue extending to its posterolateral portion. Th e tumor reached the lateral wall of the oropharynx, which showed a nonhomogeneous aspect. Th e patient underwent resection of the tumor via a conservative transmandibular approach. A clear cell adenocarcinoma of the base of the tongue is rarely a primary malignant lesion; it is more frequently a secondary lesion from a metastatic renal tumor. Because of this neoplasm's relatively slow growth rate and low incidence of metastasis or local recurrence, the gold standard of treatment is complete excision of the tumor with a suffi cient tumor-free margin.* Th e author does not provide specifi c patients' ages or follow-up, but their mean values.

Clear Cell Carcinoma of the Base of the Tongue

“…3,[5][6][7]9,11 The clear cytoplasm has been shown to contain abundant glycogen by PAS staining. 3,5,9,12,13 The immunohistochemical pattern of the tumor is characterized by immunoreactivity for epithelial antigens including cytokeratin, cytokeratin CAM 5.2, and epithelial membrane antigen (EMA). Vimentin, S-100, SMA, muscle-specific actin, and calponin are not expressed.…”

“…Vimentin, S-100, SMA, muscle-specific actin, and calponin are not expressed. 3,6,7,9,[13][14][15][16] Positivity for CD10 antigen was used for differentiating CCC from metastatic renal cell carcinoma, 9,11 but low specificities have been reviewed and recognized. 17 Recently, PAX8, which belongs to the human paired box gene family, has been shown to be a more sensitive marker for the diagnosis of primary and metastatic renal cell carcinoma.…”

“…The behavior of CCC has been assumed to be relatively indolent. It is a low-grade salivary gland malignancy 3,9,13,15,16 with an expected good prognosis. One early review estimated the 10-year survival to be 90%.…”

“…2,15 We summarize 22 cases of CCC occurring at the base of the tongue that have been published in case reports or series reports in the English literature since 1994 (Table 1). 2,3,[5][6][7][8][9][10][12][13][14][15][16][20][21][22][23] The clinical characteristics of all 23 cases, including our case, are examined. The mean age at diagnosis was 58.0 years (range, 32-81 years).…”

Histopathological analysis of metastatic tumours of the oral cavity with example of metastatic renal cell carcinoma to tongue

“…Particularly speaking about clear cell morphology tumours in the oral region, primary tumours are very rare, more often they are metastases of the CCRC 14,15 . In the differential diagnosis of the clear cell morphology oral tumours, benign lesions, primary malignant tumours and metastatic tumours should be considered 16 .…”