Clear cell odontogenic carcinoma versus hyalinizing clear cell carcinoma: A diagnostic dilemma

Abstract

Clear cell neoplasms have created a considerable dilemma in the diagnosis of head and neck pathology. Clear cells may be seen in a variety of odontogenic neoplasms, salivary gland neoplasms, and metastatic tumors to the jaws, specifically renal cell carcinoma. We present two cases of clear cell tumors - The first one, clear cell odontogenic carcinoma (CCOC), an odontogenic tumor, and the other, hyalinizing clear cell carcinoma (HCCC), a salivary gland neoplasm. Both these lesions, according to literature, have similar clinical, radiological, histopathological, and immunohistochemical features, with subtle differences. The present findings indicate that although HCCC is salivary gland in origin in the case described here, and CCOC is thought to originate from the dental lamina, and hence odontogenic in origin, both had similar growth patterns and immunohistochemical profiles, which made it impossible to distinguish these two lesions morphologically and immunohistochemically, despite a different cell of origin. These cases are presented here to share our thoughts and difficulties encountered at the time of diagnosis.