Clear cell variant of squamous cell carcinoma of skin: A report of a case
A case of a 62-year-old male, a concrete block maker/bricklayer who presented at the Dental Centre, University College Hospital, Ibadan on account of a non-healing ulcer on the left side of his face of 6 months duration. The lesion was said to have started as a small firm painless swelling in the left infra-orbital region, which gradually increased in size until 3 months later when it became ulcerated with associated pain and purulent discharge. Physical examination revealed a cachectic and pale elderly man with an obvious facial asymmetry due to a fleshy exophytic mass on the left side of the face. The patient was not a known diabetic or hypertensive and had no other known systemic disease. There was no history of tobacco or alcohol use and he was not being treated for any chronic condition. The mass measured about 16 cm in its widest diameter and extends from the left supra-orbital region to the left maxillary area and also to the left temporal area about 1 cm anterior to the left auricle. The mass caused a deviation of the lateral wall of the left nostril to the right, though clinically the nasal wall did not appear infiltrated by the tumor. It also extended superiorly such that the left eye globe could not be visualized [].\nThe exophytic mass had a necrotic central area which was covered with slough tissue. There was impaired mouth opening; the left buccal sulcus was fully obliterated by the tumor mass but the palate appeared clinically normal.\nFine needle aspiration cytology suggested a malignant epithelial neoplasm possibly a salivary gland malignancy or a skin adnexia malignant tumor. Following incisional biopsy, sections showed a malignant epithelial neoplasm composed of islands of large oval to polyhedral malignant squamous cells with eosinophilic to amphophilic cytoplasm and vesicular nuclei with some of the nuclei peripherally placed. There were areas showing clear cell differentiation of the malignant squamous cells with some cells arranged in a pseudo-glandular pattern and isolated areas showing keratin pearl formation []. Overall features were suggestive of a clear cell variant of SCC of the skin. shows lesion to be negative for periodic acid schiff (PAS), mucicarmine and alcian blue stains but was strongly positive for AE1/AE3 (immunostain).