Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2021.388
Autopsy and Case Reports
Clinical Case Report and Review

Clear cell variant of oral squamous cell carcinoma: case report and review

Rutuja Narsing Mukkanwar; Sangeeta Palaskar; Rasika Pawar; Darshana Rajesh Shah

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Abstract

The clear cell variant of Oral Squamous Cell Carcinoma (OSCC) is an uncommon histological variant. Kuo first discovered it in the skin, and Frazier et al. found it in the oral cavity. We know of only nine cases of clear cell variant of OSCC reported in the literature till now. The present case is in a 60-year-old male patient with an ulcer on the left posterolateral border of the tongue. The patient had a history of chewing tobacco for 22 years. Clinical examination showed features of malignant ulcer associated with pain and discomfort. Histopathological examination revealed sheets and islands of atypical epithelial cells with clear cytoplasm, nuclear and cellular pleomorphism, and few keratin pearls in the connective tissue suggesting OSCC. Various special stains were performed to identify clear cells. Periodic Acid Schiff-Diastase (PAS-D) and Mucicarmine stains showed positive and negative reactions in clear cells, respectively. Immunohistochemical (IHC) analysis for cytokeratin (AE1/AE3) showed diffuse positivity in clear cells and other epithelial cells. Based on special stains and IHC markers, we confirmed the diagnosis as a clear cell variant of OSCC. This variant is rare and presents diagnostic challenges. It is said to be aggressive in nature. More such cases should be reported to understand its biological behavior and prognosis.

Keywords

Carcinoma, Squamous Cell, Mouth Neoplasms, Sarcoma, Clear Cell, Squamous Cell Carcinoma of Head and Neck

References

1 Omar E. Current concepts and future of noninvasive procedures for diagnosing oral squamous cell carcinoma: a systematic review. Head Face Med. 2015;11(1):6. http://dx.doi.org/10.1186/s13005-015-0063-z. PMid:25889859.

2 Rivera C, Oliveira AK, Costa RAP, De Rossi T, Paes Leme AF. Prognostic biomarkers in oral squamous cell carcinoma: a systematic review. Oral Oncol. 2017;72:38-47. http://dx.doi.org/10.1016/j.oraloncology.2017.07.003. PMid:28797460.

3 Sharma JD, Baishya N, Kataki AC, Kalita CR, Das AK, Rahman T. Head and neck squamous cell carcinoma in young adults: a hospital-based study. Indian J Med Paediatr Oncol. 2019;40(S 01):S18-22. http://dx.doi.org/10.4103/ijmpo.ijmpo_252_17.

4 Ferlay J, Ervik M, Lam F, et al. Global cancer observatory: cancer today. Lyon: International Agency for Research on Cancer; 2020.

5 Kaliamoorthy S, Sethuraman V, Ramalingam SM, Arunkumar S. A rare case of clear cell variant of oral squamous cell carcinoma. J Nat Sci Biol Med. 2015;6(1):245-7. http://dx.doi.org/10.4103/0976-9668.149209. PMid:25810675.

6 Pathak J, Swain N, Patel S, Poonja LS. Histopathological variants of oral squamous cell carcinoma-institutional case reports. J Oral Maxillofac Pathol. 2014;18(1):143-5. http://dx.doi.org/10.4103/0973-029X.131945. PMid:24959057.

7 Shafer A, Hine M, Levy B, Rajendran R, Sivapathasundharam B. Shafer’s textbook of oral pathology. 8th ed. USA: Elsevier; 2016.

8 Kuo T. Clear cell carcinoma of the skin. A variant of the squamous cell carcinoma that simulates sebaceous carcinoma. Am J Surg Pathol. 1980;4(6):573-83. http://dx.doi.org/10.1097/00000478-198012000-00008. PMid:6163367.

9 Premalatha BR, Rao RS, Patil S, Neethi H. Clear cell tumours of the head and neck: an overview. World J Dent. 2012;3(4):344-9. http://dx.doi.org/10.5005/jp-journals-10015-1187.

10 Kakoti LM, Mahanta D, Sharma JD, Chowdhury Z. Clear-cell squamous cell carcinoma: an uncommon variant of very common malignancy in the head and neck. Int J Oral Health Sci. 2018;8(2):136-9. http://dx.doi.org/10.4103/ijohs.ijohs_23_18.

11 Frazier JJ, Sacks H, Freedman PD. Primary glycogen-rich clear cell squamous cell carcinoma of the mandibular gingiva. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(5):e47-51. http://dx.doi.org/10.1016/j.oooo.2012.01.033. PMid:23083485.

12 Ramani P, Gheena S, Karunagaran M, Hannah R. Clear-cell variant of oral squamous cell carcinoma: a rare entity. J Oral Maxillofac Pathol. 2021;25(4, Suppl. 1):S22-6. http://dx.doi.org/10.4103/jomfp.JOMFP_295_20. PMid:34083965.

13 Corbalán-Vélez R, Ruiz-Macia JA, Brufau C, López-Lozano JM, Martínez-Barba E, Carapeto FJ. Clear cells in cutaneous squamous cell carcinoma. Actas Dermosifiliogr. 2009;100(4):307-16. PMid:19463234.

14 Jain A, Shetty DC, Juneja S, Narwal N. Molecular characterization of clear cell lesions of head and neck. J Clin Diagn Res. 2016;10(5):ZE18-23. http://dx.doi.org/10.7860/JCDR/2016/14394.7867. PMid:27437379.

15 Kumar K, Shetty DC, Wadhwan V, Gupta P. Synchronous oral squamous cell carcinomas with unusual histopathological feature. J Oral Maxillofac Pathol. 2012;16(3):420-4. http://dx.doi.org/10.4103/0973-029X.102506. PMid:23248478.

16 Nainani P, Singh HP, Paliwal A, Nagpal N. A rare case report of clear cell variant of oral squamous cell carcinoma. J Clin Diagn Res. 2014;8(12):QD07-09. http://dx.doi.org/10.7860/JCDR/2014/11536.5339. PMid:25654003.

17 Romañach M, Canedo N, Cortezzi E, Abrahão A, Cabral M, Agostini M. Clear cell variant of oral squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(6):e195. http://dx.doi.org/10.1016/j.oooo.2014.05.102.

18 Devi A, Kamboj M, Singh V, Singh S. Clear-cell variant of squamous cell carcinoma in maxilla as primary lesion: a rare case. J Oral Maxillofac Pathol. 2017;21(3):425-8. http://dx.doi.org/10.4103/jomfp.JOMFP_180_16. PMid:29391719.

19 Khoury ZH, Bugshan A, Lubek JE, Papadimitriou JC, Basile JR, Younis RH. Glycogen-rich clear cell squamous cell carcinoma originating in the oral cavity. Head Neck Pathol. 2017;11(4):552-60. http://dx.doi.org/10.1007/s12105-017-0812-3. PMid:28342060.
 


Submitted date:
07/23/2021

Accepted date:
05/30/2022

Publication date:
07/15/2022

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