Clinical Pathologic Conference Case 4: Hylanizing Clear Cell Carcinoma

Excerpt

A 40-year-old female, in relatively good health, presented to her primary care physician for a cold. During an exam of her oropharynx, the physician inquired about a 1.5 × 1.5 cm lump on the posterior aspect of her tongue. The patient reported not knowing of its presence. The patient then inquired of her dentist if he had ever noticed this lesion, which he had not. Her general dentist then referred the patient to the University of California San Francisco Department of Oral and Maxillofacial Surgery for evaluation. Upon examination by an oral and maxillofacial surgeon, the patient had an exophytic, circumscribed, smooth surfaced, somewhat reddened mass posterior to the left circumvallate papillae (Fig. 1). There was no submandibular or cervical LAD. The patient was completely asymptomatic and did not report dysphagia or dysphonia. Magnetic resonance images showed an infiltrative, homogenous lesion of approximately 1.5 × 1.5 cm in diameter in the left posterior portion of the tongue that was mostly exophytic but extended into the skeletal muscle (Fig. 2). Cervical lymph nodes were also not evident by imaging.

…