Nasopharyngeal Microcystic Clear Cell Adenoma in a Child: A Rare Case Report.

Abstract

Adenoidectomy, routinely performed for pediatric obstructive symptoms, typically reveals benign lymphoid hyperplasia. We report the first documented case of a primary clear cell microcystic adenoma within adenoid tissue in a 12-year-old male undergoing adenotonsillectomy for chronic snoring, recurrent tonsillitis, and mouth breathing. Intraoperative examination identified an unusual homogenous grayish-white adenoid mass. Histopathological analysis demonstrated benign epithelial hyperplasia with focal clusters of clear cells arranged in microcystic patterns, morphologically aligning with a low-grade microcystic adenoma-a lesion classically linked to von Hippel-Lindau (VHL) syndrome. This case emphasizes the critical role of histopathological scrutiny in routine surgical specimens, as incidental findings may reveal rare neoplasms with significant syndromic implications. While the lesion exhibited benign features, its histological resemblance to VHL-driven neoplasms necessitates vigilant long-term surveillance. This report advocates for multidisciplinary collaboration in managing such cases and highlights the importance of genetic assessment to guide familial screening. Further documentation of similar cases is required to establish this entity's clinical and molecular profile, refining diagnostic approaches for nasopharyngeal clear cell lesions.