Reappraising hyalinizing clear cell carcinoma: A population-based study with molecular confirmation

Head Neck. 2017 Mar;39(3):503-511. doi: 10.1002/hed.24637. Epub 2016 Nov 29.

Abstract

Background: Hyalinizing clear cell carcinoma (HCCC) is a rare malignancy, characterized by EWSR1-ATF1 gene fusion, whose behavior is poorly understood, as it was for many years considered a diagnosis of exclusion.

Methods: All available salivary gland carcinomas (n = 594) from our institution were reviewed. Diagnosis of HCCC was confirmed by fluorescence in situ hybridization (FISH) for EWSR1. Literature review was performed.

Results: We found 15 patients with HCCCs (10 women, 5 men), 13 with EWSR1 rearrangement. Median age at diagnosis was 57 years (range, 31-87 years). Oral cavity (n = 9) and base of tongue (n = 4) were the most frequent primary sites. Combining our cases with those identified in literature review, the 10-year risk of local recurrence and locoregional nodal metastasis were 49% and 15%, respectively.

Conclusion: Molecularly confirmed HCCC accounted for 2.5% of salivary gland malignancies at our institution. HCCCs are indolent tumors with a propensity for locoregional recurrence. © 2016 Wiley Periodicals, Inc. Head Neck 39: 503-511, 2017.

Keywords: EWSR1; clear cell carcinoma; hyalinizing clear cell carcinoma; salivary gland.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Activating Transcription Factor 1 / genetics*
  • Adenocarcinoma, Clear Cell / diagnostic imaging
  • Adenocarcinoma, Clear Cell / genetics*
  • Adenocarcinoma, Clear Cell / pathology
  • Adenocarcinoma, Clear Cell / therapy
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / genetics*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • RNA-Binding Protein EWS / genetics*
  • RNA-Binding Proteins / genetics
  • Retrospective Studies
  • Salivary Gland Neoplasms / diagnostic imaging
  • Salivary Gland Neoplasms / genetics*
  • Salivary Gland Neoplasms / pathology
  • Salivary Gland Neoplasms / therapy
  • Survival Rate

Substances

  • ATF1 protein, human
  • Activating Transcription Factor 1
  • EWSR1 protein, human
  • RNA-Binding Protein EWS
  • RNA-Binding Proteins