Hyalinizing clear cell carcinoma of the parotid gland: Report of a recurrent case with aggressive cytomorphology and behavior diagnosed on fine‐needle cytology sample

Abstract

A case of recurrent hyalinizing clear cell carcinoma (HCCC) of the parotid gland in a 46-year-old female is here introduced. The patient had undergone a left superficial parotidectomy 6 months ago in another institution for an alleged benign, circumscribed mass 2.4 cm in diameter of the left parotid gland. Histopathological examination revealed a poorly differentiated HCCC bearing a EWSR-1 translocation on FISH examination. Fine Needle Cytology (FNC) was performed on three separate soft tissue masses in the pre-masseterine area and a cytological diagnosis of recurrent, poorly differentiated, possibly aggressive variant of HCCC, was rendered. FISH performed on a destained Diff Quik stained smear demonstrated an ESWR-1 translocation, which supported the cytopathological diagnosis. The cytomorphologic features and the differential diagnosis of this aggressive variant of HCCC are briefly discussed.

Nasopharyngeal hyalinizing clear cell carcinoma with EWSR1 rearrangements diagnosed by fluorescence in situ hybridization

“…Fulciniti et al [11] diagnosed a recurrent, poorly differentiated HCCC of the parotid gland by identifying EWSR1 translocation by FISH analysis of fine needle cytology (FNC) sampling of three separate soft tissue masses in the pre-masseterine area. Jin et al [12] reported EWSR1 rearrangement in a case of recurrent HCCC at the base of the tongue with high-grade transformation by FISH, which is a reliable and relatively accessible method to diagnose HCCC in samples acquired by FNC as well as small biopsies.…”

Very delayed cervical lymph node metastases from hyalinizing clear cell carcinoma: Report of 2 cases

“…HCCC occurs predominantly in the minor salivary glands, and the most common sites of occurrence are the tongue and palate . HCCC has also been identified in the parotid gland …”

“…Although HCCC is accepted as an overall indolent malignancy with favorable outcomes, sporadic case reports have noted examples of aggressive tumor behavior, such as rapid or repeated local recurrence and the development of pulmonary or osseous metastases . In a 2009 review of the literature, Solar et al reviewed 52 reported cases of HCCC in the English literature and discovered that, among these patients, 23% presented with evidence of metastatic spread and 11.5% developed recurrent disease after treatment.…”

Envisioning the Next WHO Head and Neck Classification

“…Review of the literature confirms that the rate of cervical lymph node metastases is approximately 25 % and one-third of patients have developed local recurrence. Although classified as a low-grade malignancy, pulmonary metastases, widespread metastases, and diseaserelated mortality are uncommon but documented [36,37,39,[41][42][43][44]. Progression in histological grade (high-grade transformation), e.g.…”

“…Progression in histological grade (high-grade transformation), e.g. increased mitotic rate, necrosis, and cytologic anaplasia, have been described in patients who develop disease-progression [41,42,44,45].…”