Hyalinizing clear cell carcinoma of the nasopharyngeal minor salivary glands: an unusual case report

Introduction and importance: This case presents an uncommon instance of hyalinizing clear cell carcinoma (HCCC) of minor salivary glands presented as a mass resembling a nasal polyp in nasal cavities, emphasizing its rarity, diagnostic complexity, and the essential role of immunohistochemistry in accurate identification. Case presentation: A 15-year-old girl presented in the general outpatient department with progressive nasal congestion for 2.5 years, along with allergic rhinitis, mouth breathing, sleep apnea, and rhinorrhea, further leading to ear blockage and purulent otorrhea. Examination revealed a smooth, lobulated mass on the posterior nasopharyngeal wall extending into the nasal cavity. CT and MRI confirmed a well-defined, homogeneously enhancing 3.4 × 5.0 × 6.4 cm mass. Histopathology showed fibrotic stroma and clear cells. Immunohistochemistry was positive for pan Cytokeratin (AE1/AE3), p63, and CK-7, while Smooth Muscle Antibody, S-100, and GFAP were negative, confirming the diagnosis. The patient underwent endoscopic transpalatal surgical excision with clear margins and recovered well, with no relapse at 1-year follow-up. Clinical discussion: HCCC is a rare low-grade malignancy with indolent growth but potential for recurrence. Its unusual presentation as a nasal mass often mimics benign conditions, causing delay. Imaging aids evaluation, but immunohistochemistry is vital to distinguish it from other clear cell tumors. Complete surgical excision with negative margins is the treatment of choice, and follow-up is crucial to detect recurrence. Conclusion: This case highlights the importance of early recognition and accurate diagnosis of HCCC to ensure curative surgical outcomes and prevent metastasis.