Hyalinizing Clear Cell Carcinoma with Biopsy-Proven Spinal Metastasis: Case Report and Review of Literature

World Neurosurg. 2016 Jun:90:699.e7-699.e10. doi: 10.1016/j.wneu.2016.02.001. Epub 2016 Feb 6.

Abstract

Background: Hyalinizing clear cell carcinoma (HCCC) is a rare epithelial malignant neoplasm typically arising from the minor salivary glands. Although it has been described as a benign neoplasm, there are increasing reports of malignant features and metastases to the lungs; we present the first case of biopsy-proven spinal metastases from HCCC and an overview of the literature.

Case description: This is a single-patient case report in which we used immunohistochemistry and fluorescence in situ hybridization for Ewing sarcoma breakpoint region 1 translocation to confirm the diagnosis of HCCC in a spinal metastasis. The diagnosis of metastatic HCCC was confirmed on the basis of histopathology, immunohistochemistry, and fluorescence in situ hybridization studies.

Conclusions: We present the first pathologically confirmed case of a spinal metastasis in HCCC. As increasing of metastatic HCCC arise, a reconsideration of HCCC as a potentially high-grade disease seems increasingly necessary as it may impact the current treatment paradigm.

Keywords: EWSR1-ATF1; Fluorescence in situ hybridization; Histopathology; Hyalinizing clear cell carcinoma; Spine metastasis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Female
  • Genetic Testing
  • Humans
  • Salivary Gland Neoplasms / genetics
  • Salivary Gland Neoplasms / pathology*
  • Sarcoma, Clear Cell / genetics
  • Sarcoma, Clear Cell / pathology*
  • Sarcoma, Clear Cell / secondary*
  • Spinal Neoplasms / genetics
  • Spinal Neoplasms / pathology*
  • Spinal Neoplasms / secondary*