Fujita Hiromi, Iida Masao, Imura Johji, Shinagawa Yasuhiro, Omotehara Fumie, Kawamata Hitoshi, Imai Yutaka, Fujimori Takahiro
Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine, Shimotsuga, Tochigi, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Nov;98(5):579-82. doi: 10.1016/j.tripleo.2004.03.022.
A firm, ulcerated tumor formed on the left side of the tongue of an elderly woman. Histopathological analysis showed that this unusual neoplasm was composed of monomorphic polygonal cells that exhibited a clear cytoplasm containing large amounts of periodic acid Schiff (PAS)-positive, diastase-digestive material. Most of the tumor cells stained immunohistochemically for Cytokeratin, high-molecular, CAM5.2, and epithelial membrane antigen (EMA), but were negative for alpha-smooth muscle actin, vimentin, glial fibrillary acid protein (GFAP), and S-100 protein. These findings supported a diagnosis of clear cell adenocarcinoma. Although patients with this type of tumor generally have a favorable prognosis, the tumor in our patient was fast-growing and contained a large number of Ki-67 positive cells, which are known to be highly proliferative. Thus, this case highlights the fact that even clear cell adenocarcinomas that are usually slow-growing should be investigated by conventional morphological techniques and their proliferative activity quantified in order to select the most appropriate treatment strategy.
