Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?

Primary clear cell microcystic adenoma of the sinonasal cavity is rare. It has previously been described only as a VHL-associated tumour. Von Hippel-Lindau (VHL) syndrome is an inherited cancer syndrome characterised by an elevated risk of neoplasia including clear cell renal cell carcinoma (ccRCC),...

Full description

Saved in:
Bibliographic Details
Main Authors: Rosalin Cooper, Hannah Markham, Jeffery Theaker, Adrian Bateman, David Bunyan, Matthew Sommerlad, Gillian Crawford, Diana Eccles
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Pathology
Online Access:http://dx.doi.org/10.1155/2017/9236780
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849684650654433280
author Rosalin Cooper
Hannah Markham
Jeffery Theaker
Adrian Bateman
David Bunyan
Matthew Sommerlad
Gillian Crawford
Diana Eccles
author_facet Rosalin Cooper
Hannah Markham
Jeffery Theaker
Adrian Bateman
David Bunyan
Matthew Sommerlad
Gillian Crawford
Diana Eccles
author_sort Rosalin Cooper
collection DOAJ
description Primary clear cell microcystic adenoma of the sinonasal cavity is rare. It has previously been described only as a VHL-associated tumour. Von Hippel-Lindau (VHL) syndrome is an inherited cancer syndrome characterised by an elevated risk of neoplasia including clear cell renal cell carcinoma (ccRCC), haemangioblastoma, and phaeochromocytoma. We describe the second reported case of a primary clear cell microcystic adenoma of the sinonasal cavity. The 39-year-old patient with VHL syndrome had previously undergone resection and ablation of ccRCC. He presented with epistaxis. Imaging demonstrated a mass in the ethmoid sinus. Initial clinical suspicion was of metastatic ccRCC. However, tumour morphology and immunoprofile were distinct from the previous ccRCC and supported a diagnosis of primary microcystic adenoma. Analysis of DNA extracted from sinonasal tumour tissue did not show loss of the wild-type allele at the VHL locus. Although this did not support tumour association with VHL disease, it was not possible to look for a loss-of-function mutation. The association of primary microcystic adenoma of the sinonasal cavity with VHL disease remains speculative. These lesions are benign but are likely to require regular surveillance. Such tumours may require repeated surgical excision.
format Article
id doaj-art-c082f1e7837a46b2b41b6c6bf2172f7a
institution DOAJ
issn 2090-6781
2090-679X
language English
publishDate 2017-01-01
publisher Wiley
record_format Article
series Case Reports in Pathology
spelling doaj-art-c082f1e7837a46b2b41b6c6bf2172f7a2025-08-20T03:23:24ZengWileyCase Reports in Pathology2090-67812090-679X2017-01-01201710.1155/2017/92367809236780Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?Rosalin Cooper0Hannah Markham1Jeffery Theaker2Adrian Bateman3David Bunyan4Matthew Sommerlad5Gillian Crawford6Diana Eccles7Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UKDepartment of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UKDepartment of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UKDepartment of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UKWessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UKDepartment of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UKUniversity of Southampton, Southampton, UKUniversity of Southampton, Southampton, UKPrimary clear cell microcystic adenoma of the sinonasal cavity is rare. It has previously been described only as a VHL-associated tumour. Von Hippel-Lindau (VHL) syndrome is an inherited cancer syndrome characterised by an elevated risk of neoplasia including clear cell renal cell carcinoma (ccRCC), haemangioblastoma, and phaeochromocytoma. We describe the second reported case of a primary clear cell microcystic adenoma of the sinonasal cavity. The 39-year-old patient with VHL syndrome had previously undergone resection and ablation of ccRCC. He presented with epistaxis. Imaging demonstrated a mass in the ethmoid sinus. Initial clinical suspicion was of metastatic ccRCC. However, tumour morphology and immunoprofile were distinct from the previous ccRCC and supported a diagnosis of primary microcystic adenoma. Analysis of DNA extracted from sinonasal tumour tissue did not show loss of the wild-type allele at the VHL locus. Although this did not support tumour association with VHL disease, it was not possible to look for a loss-of-function mutation. The association of primary microcystic adenoma of the sinonasal cavity with VHL disease remains speculative. These lesions are benign but are likely to require regular surveillance. Such tumours may require repeated surgical excision.http://dx.doi.org/10.1155/2017/9236780
spellingShingle Rosalin Cooper
Hannah Markham
Jeffery Theaker
Adrian Bateman
David Bunyan
Matthew Sommerlad
Gillian Crawford
Diana Eccles
Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?
Case Reports in Pathology
title Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?
title_full Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?
title_fullStr Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?
title_full_unstemmed Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?
title_short Primary Clear Cell Microcystic Adenoma of the Sinonasal Cavity: Pathological or Fortuitous Association?
title_sort primary clear cell microcystic adenoma of the sinonasal cavity pathological or fortuitous association
url http://dx.doi.org/10.1155/2017/9236780
work_keys_str_mv AT rosalincooper primaryclearcellmicrocysticadenomaofthesinonasalcavitypathologicalorfortuitousassociation
AT hannahmarkham primaryclearcellmicrocysticadenomaofthesinonasalcavitypathologicalorfortuitousassociation
AT jefferytheaker primaryclearcellmicrocysticadenomaofthesinonasalcavitypathologicalorfortuitousassociation
AT adrianbateman primaryclearcellmicrocysticadenomaofthesinonasalcavitypathologicalorfortuitousassociation
AT davidbunyan primaryclearcellmicrocysticadenomaofthesinonasalcavitypathologicalorfortuitousassociation
AT matthewsommerlad primaryclearcellmicrocysticadenomaofthesinonasalcavitypathologicalorfortuitousassociation
AT gilliancrawford primaryclearcellmicrocysticadenomaofthesinonasalcavitypathologicalorfortuitousassociation
AT dianaeccles primaryclearcellmicrocysticadenomaofthesinonasalcavitypathologicalorfortuitousassociation