Hyalinizing Clear Cell Carcinoma of the Base of Tongue: First Report of a Case Presenting With Headaches

OBJECTIVE: To report the first case of hyalinizing clear cell carcinoma (HCCC) with headaches as the presenting complaint and to emphasize importance of early diagnosis and treatment of this rare tumor which we believe is not as indolent as reported previously.BACKGROUND: HCCC is a rare, low-grade, malignant tumor of minor salivary glands which commonly involves the mucosa of oral cavity. This distinct clinico-pathological entity accounts for less than 1[percnt] of all salivary gland tumors. A rare location of this tumor is base of tongue, and only 12 cases (22[percnt]) have been reported at this site. It is commonly reported in females and the most common clinical presentation is a painless swelling.DESIGN: We report case of a 60 year old male with 2 year history of headaches and new onset dysphagia and dysarthria.RESULTS: CT-neck demonstrated a new hypodense, cystic lesion at left-base of tongue with another smaller cystic nodule in left level-III region, absent on comparison CT-neck in 2013. Initial cytomorphology and immunoprofile were consistent with poorly-differentiated salivary gland carcinoma with concerns for metastasis (pT2N1M0). Transcervical-resection of base of tongue was performed with limited left neck dissection. Pathology results came back for HCCC of minor salivary glands. Patient underwent post-op radiotherapy. He was seen in clinic four months later with no new complaints. He denied any headaches or neck pain, had passed swallow test and slurring of speech also improved.CONCLUSION: After reviewing the 55 cases of HCCC reported so far, we present first case of HCCC with headaches as the chief complaint. This case is unique not only by its clinical presentation but is also rare in terms of patient’s sex, site of tumor and presence of nodal metastasis.Additional cases need to be reported to further define the behavior and clinical presentation of this rare tumor. Disclosure: Dr. Farooq has nothing to disclose. Dr. Harding-Jackson has nothing to disclose. Dr. Stadler has nothing to disclose. Dr. Freitag has received personal compensation for activities with GlaxoSmithKline, Zogenix, Nautilus Pharm, Merck, Allergan, MAP, Transcept Pharmaceuticals, and NuPathe as a speaker or consultant.