Clear cell variant of oral squamous cell carcinoma

Rationale: The report highlights a rare variant of oral squamous cell carcinoma (OSCC) showing clear cell change, emphasizing differential diagnosis and accurate clinical management. Patient Concerns: A 68-year-old woman who chewed Mishri for 25 years, which is a smokeless tobacco linked to oral cancer, presented with a proliferative growth in the left upper gingiva-buccal sulcus. The teeth exhibited mobility. Diagnosis: Histopathological examination of the biopsy revealed sheets of periodic acid-schiff-positive glycogen-rich clear cells with pleomorphism comprising more than 50% of tumor cells and squamous cell islands extending from the dysplastic epithelium. The diagnosis of clear cell variant OSCC (CCV-OSCC) was rendered. Interventions: Segmental Maxillectomy was performed. Outcomes: 6-month follow-up was uneventful. Lessons: Accurate histopathological diagnosis is crucial for distinguishing CCV-OSCC from other clear cell neoplasms for appropriate treatment. Despite limited survival data, this variant often exhibits an aggressive clinical course, requiring close monitoring for recurrence and metastasis.