International Journal of Head and Neck Pathology

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Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic malignancy with a female preponderance occurring in the adult age group. CCOC was classified as a malignant neoplasm of odontogenic origin by the World Health Organization in 2005 because of its aggressive nature, local recurrence tendency, and the potential for regional and distant metastasis. Histologically, CCOC is characterized by sheets and islands of vacuolated and clear cells. Metastasis at presentation is rare; it usually involves cervical lymph nodes and lungs, less frequently to bone. As clear cells are present in few odontogenic tumors; salivary gland neoplasms; and metastatic tumors to the jaws, especially metastatic renal cell carcinoma, the presence of clear cells in a lesion of the head and neck region poses a diagnostic challenge. So knowledge about the clinical course, histopathological pattern, and immunoprofile of CCOC helps in differentiating the other clear cell tumors.

The Corona virus pandemic and its continued streak along with numerous mutations have put forth a major challenge for the medical fraternity worldwide. Due to new disease entity with high infectivity rate and associated fatality, it is proving to be highly challenging by being associated with certain morbidities induced by novel therapeutic protocols. Some of the COVID-19 treated patients suffer with another fatal infection, mucormycosis, commonly called as black fungus and this has posed yet another challenge in fighting the COVID menace. The paper features mucormycosis as a preexisting entity in medical science along with its current hazardous trend with novel corona virus including its management.

A 35-year-old gentleman presented with headache in the occipital region, neck pain, slurring of speech, and vomiting. There was reported history of Von Hippel–Lindau disease (VHL) in his mother, who was operated for a cerebellar hemangioblastoma. On investigations, magnetic resonance imaging brain showed bilateral cerebellar hemangioblastomas and a tiny spinal hemangioblastoma. Contrast-enhanced computed tomography abdomen showed multiple small well-defined, non-enhancing hypodense lesions with fluid attenuation in the left kidney and pancreas, suggestive of simple cysts. There was history of right partial nephrectomy in the past for renal cell carcinoma. Complete excision of bilateral cerebellar hemangioblastomas was performed. Histopathological examination and immunohistochemical workup confirmed the clinical diagnosis of hemangioblastoma.

The presence of multiple malignancies of different histologies occurring synchronously is very rare and is reported in limited numbers across the literature. We hereby report a case presenting with papillary carcinoma of thyroid gland and mucoepidermoid carcinoma of parotid gland accompanied by regional lymph node metastasis of both the aforementioned malignancies. Recognition of such tumors is quintessential as the management and prognosis vary.

Online since 16^th May 2018.