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AP AS, N SK, V. M. Kutty S, Manoharan S, K B, E P. Lymphoepithelial Carcinoma: A rare Presentation in the Hypopharynx. Indian J Otolaryngol Head Neck Surg 2024; 76:2075-2077. [PMID: 38566665 PMCID: PMC10982281 DOI: 10.1007/s12070-023-04408-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/23/2023] [Indexed: 04/04/2024] Open
Abstract
Hypopharyngeal origin of lymphoepithelial carcinoma is extremely rare. We report a case of 74 years old male presented with Globus sensation in the throat for 2 months. He underwent total laryngectomy with partial pharyngectomy after clinico-radiological evaluation and biopsy. His final diagnosis was lymphoepithelial carcinoma and IHC was positive for pancytokeratin and p63.
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Affiliation(s)
- Ameen Sumais AP
- Head and Neck Surgical Oncology, MVR Cancer Center and Research Institute, Calicut, India
| | - Santhosh Kumar N
- Head and Neck Surgical Oncology, MVR Cancer Center and Research Institute, Calicut, India
| | | | - Sudheesh Manoharan
- Head and Neck Surgical Oncology, MVR Cancer Center and Research Institute, Calicut, India
| | - Bharathi K
- Oral oncology, MVR Cancer center and research institute, Calicut, India
| | - Padma E
- Oral oncology, MVR Cancer center and research institute, Calicut, India
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Niu X, Liu P, Wang X, Hu C. Is radical radiotherapy with/without surgery an effective treatment in the lymphoepithelial carcinoma of the salivary gland?. BMC Cancer 2023; 23:968. [PMID: 37828474 PMCID: PMC10568878 DOI: 10.1186/s12885-023-11466-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND There is limited information of radical radiotherapy (RT) on lymphoepithelial carcinoma of salivary gland (LECSG) regarding to the rarity of the disease. We conducted this retrospective study that evaluated the feasibility and efficacy of radical RT with/without surgery in LECSG. METHODS We retrospectively reviewed patients that were pathologically diagnosed of LECSG and had definite or suspicious residual disease. The prescribed dose given to P-GTV and/or P-GTV-LN was 66 to 70.4 Gy. The clinical target volume (CTV) involved ipsilateral salivary gland and corresponding lymph node drainage area. RESULTS A total of 56 patients were included. With a median follow-up of 60 months (range: 8 to 151 months), the 1-, 5-, and 10-year progression-free survival (PFS) rates were 94.6%, 84.7% and 84.7%; locoregional progression-free survival (LRPFS) rates were 98.2%, 87.4% and 87.4%; distance metastasis-free survival (DMFS) rates were 94.6%, 86.7% and 86.7%; and overall survival (OS) rates were 98.2%, 92.4% and 89.0%, respectively. A total of 7 patients without surgery were included. All patients were alive and only one patient experienced failure of distant metastasis four months after RT. The results of univariate analysis showed that compared with N stage, the number of positive lymph nodes (2 positive lymph nodes) was better prognostic predictor especially in PFS. There were no treatment-related deaths and most toxicities of RT were mild. CONCLUSIONS Radical RT with/without surgery in LECSG for definite or suspicious residual disease is feasibility and efficacy. Most toxicities of RT were mild due to the target volume involved ipsilateral area.
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Affiliation(s)
- Xiaoshuang Niu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Department of Radiation Oncology, Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Peiyao Liu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- Department of Radiation Oncology, Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Xiaoshen Wang
- Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, China.
| | - Chaosu Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
- Department of Radiation Oncology, Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China.
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.
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Liu ZQ, Feng YF, Xiao Y, Zhang XM, Li JB, Xie FY, Mao YP. Clinical characteristics, prognostic factors, and treatment modalities for head and neck lymphoepithelioma-like carcinoma: A real-world study from southern China. Radiother Oncol 2023; 187:109814. [PMID: 37480992 DOI: 10.1016/j.radonc.2023.109814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND We aimed to elucidate the clinical characteristics, prognostic factors and optimal treatment modalities of head and neck lymphoepithelioma-like carcinoma (HNLELC). METHODS Consecutive patients newly-diagnosed with non-metastatic HNLELC between December 2001 and March 2021 treated with curative intent were retrospectively reviewed. RESULTS A total of 288 patients were included, of whom 87 (30.2%) underwent radical surgery alone, 43 (14.9%) underwent definitive radiotherapy with or without concurrent chemotherapy, and 158 (54.9%) underwent surgery followed by postoperative radiotherapy (SRT). Epstein-Barr virus-encoded small RNA (EBER) was positive in 94.8% (239/252) of patients. Cervical node infiltration was seen in 52.8% (152/288) of patients. No significant difference was found in nodal metastasis rate between T1-2 and T3-4 classifications (49.5% vs. 56.5%, p = 0.308). The 3-year overall survival (OS), disease-free survival, locoregional relapse-free survival, and distant metastasis-free survival rates were 89.4%, 78.7%, 89.2%, and 87.7%, respectively. Compared to SRT, surgery alone associated with significant reduced 3-year local (92.8% vs. 96.5%, p = 0.012) and regional relapse-free survival rates (89.3% vs. 96.8%, p = 0.002). Definitive radiotherapy and SRT demonstrated comparable results in all 3-year survival outcomes (all p>0.05). Multivariate analysis found EBER status was an independent favorable prognostic factor for OS (HR = 0.356, 95% CI: 0.144-0.882, p = 0.026). CONCLUSION HNLELC was observed to associate with EBV infection and cervical nodal infiltration. Definitive radiotherapy achieved similar survival outcomes compared to SRT, and may serve as a good substitute for patients unfit or unwilling to undergo surgery.
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Affiliation(s)
- Zhi-Qiao Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Yan-Fen Feng
- Department of Pathology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Yao Xiao
- Zhujiang Clinical Skill Training Center, Zhujiang Hospital of Southern Medical University, Guangzhou, PR China
| | - Xiao-Min Zhang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China
| | - Ji-Bin Li
- Clinical Trials Centre, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Fang-Yun Xie
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China.
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, PR China.
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Qiu Z, Wu Z, Zhou X, Lin F, Lyu S, Su Y, Tao Y. Could definitive radiotherapy be a treatment option for lymphoepithelial carcinoma of major salivary gland: Comparison of clinical outcomes of upfront surgery and upfront chemoradiotherapy. Oral Oncol 2023; 143:106443. [PMID: 37295063 DOI: 10.1016/j.oraloncology.2023.106443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The optimal treatment and associated clinical outcomes for lymphoepithelial carcinoma of the major salivary gland (LECSG) are currently unclear. As such, the purpose of this study was to assess the survival rates of LECSG patients who received either upfront surgery or upfront chemoradiotherapy (CRT). MATERIALS AND METHODS In this retrospective study, we analyzed cases of LECSG patients treated at our center from January 2010 to April 2021. The cumulative incidences of overall survival rate (OS) and locoregional failure-free survival rate (LRFFS) were evaluated using the Kaplan-Meier method. In order to balance potential risk factors between the treatment groups, we conducted propensity score matching (PSM) at a 1:1 ratio. RESULTS The study enrolled a total of 107 patients, among whom 24 received surgery alone, 56 underwent surgery combined with postoperative radiotherapy, and 27 underwent definitive radiotherapy. The 5-year LRFFS rate and 5-year OS rate for the entire cohort were 86.6% and 84.4%, respectively. Following PSM, the 5-year LRFFS and OS rates for the upfront CRT cases were comparable to those of upfront surgery, both before and after matching. However, the upfront surgery group showed a tendency toward more de novo facial nerve injury and post-treatment facial nerve injury. CONCLUSION The results of this study suggest that upfront CRT is as effective as upfront surgery in terms of locoregional control and overall survival for LECSG patients. Therefore, upfront CRT could be considered a viable treatment option, potentially avoiding the risks associated with surgical intervention.
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Affiliation(s)
- Zichen Qiu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou 510060, PR China
| | - Zheng Wu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, 283 Tong Zi Po Road, Changsha 410013, PR China
| | - Xiong Zhou
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou 510060, PR China
| | - Feifei Lin
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou 510060, PR China
| | - Shaowen Lyu
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Yong Su
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou 510060, PR China.
| | - Yalan Tao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou 510060, PR China.
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Pérez IMM, Pérez SEM, García RP, Lupgens DDZ, Martínez GB, González CR, Yán NK, Hernández FR. Exercise-based rehabilitation on functionality and quality of life in head and neck cancer survivors. A systematic review and meta-analysis. Sci Rep 2023; 13:8523. [PMID: 37237097 DOI: 10.1038/s41598-023-35503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Head and Neck Cancer (HNC) is a globally rare cancer that includes a variety of tumors affecting the upper aerodigestive tract. It presents with difficulty breathing or swallowing and is mainly treated with radiation therapy, chemotherapy, or surgery for tumors that have spread locally or throughout the body. Alternatively, exercise can be used during cancer treatment to improve function, including pain relief, increase range of motion and muscle strength, and reduce cancer-related fatigue, thereby enhancing quality of life. Although existing evidence suggests the adjunctive use of exercise in other cancer types, no previous studies have examined the effects on HNC survivors. The aim of this meta-analysis was to quantify the effect of exercise-based rehabilitation on functionality and quality of life in HNC survivors who underwent surgery and/or chemoradiotherapy. A systematic review and meta-analysis were carried out following PRISMA statement and registered in PROSPERO (CRD42023390300). The search was performed in MEDLINE (PubMED), Cochrane Library, CINAHL and Web of Science (WOS) databases from inception to 31st December 2022 using the terms "cancer", "head and neck neoplasms", "exercise", "rehabilitation", "complications", "muscle contraction", "muscle stretching exercises" combining with booleans "AND"/"OR". PEDro scale, Cochrane Risk of Bias Tool and GRADE were used to assess methodological quality, risk of bias and grade of recommendation of included studies respectively. 18 studies (n = 1322) were finally included which 1039 (78.6%) were men and 283 (21.4%) were women. In patients who underwent radio-chemotherapy, overall pain [SMD = - 0.62 [- 4.07, 2.83] CI 95%, Z = 0.35, p = 0.72] and OP [SMD = - 0.07 [- 0.62, 0.48] CI 95%, Z = 0.25, p = 0.81] were slightly reduced with exercise in comparison to controls. Besides, lower limb muscle strength [SMD = - 0.10 [- 1.52, 1.32] CI 95%, Z = 0.14, p = 0.89] and fatigue [SMD = - 0.51 [- 0.97, - 0.057] CI 95%, Z = 2.15, p < 0.01] were also improved in those who receive radio-chemoradiation. In HNC survivors treated with neck dissection surgery, exercise was superior to controls in overall pain [SMD = - 1.04 [- 3.31, 1.23] CI 95%, Z = 0.90, p = 0.37] and, in mid-term, on shoulder pain SMD = - 2.81 [- 7.06, 1.43] CI 95%, Z = 1.76, p = 0.08]. No differences in quality of life were found at any of the follow-up periods. There is evidence of fair to good methodological quality, low to moderate risk of bias, and weak recommendations supporting the use of exercise-based rehabilitation to increase functionality. However, no evidence was found in favor of the use of this modality for improving the quality of life of HNC survivors who underwent chemoradiotherapy or surgery.
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Affiliation(s)
- Isidro Miguel Martín Pérez
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
- Escuela de Doctorado y Estudios de Posgrado, Universidad de la Laguna, 38203, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Sebastián Eustaquio Martín Pérez
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain.
- Escuela de Doctorado y Estudios de Posgrado, Universidad de la Laguna, 38203, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain.
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300, La Orotava, Santa Cruz de Tenerife, Spain.
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Madrid, Spain.
| | - Raquel Pérez García
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
| | - Diego de Zárate Lupgens
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300, La Orotava, Santa Cruz de Tenerife, Spain
| | - Germán Barrachina Martínez
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300, La Orotava, Santa Cruz de Tenerife, Spain
| | - Carolina Rodríguez González
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
- Hospital Universitario de Canarias, 38320, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
| | - Nart Keituqwa Yán
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
- Hospital Universitario de Canarias, 38320, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
| | - Fidel Rodríguez Hernández
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
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Lymphoepithelial Subtype of Oral Squamous Cell Carcinoma: Report of an EBV-Negative Case and Literature Review. Dent J (Basel) 2022; 10:dj10090165. [PMID: 36135160 PMCID: PMC9497543 DOI: 10.3390/dj10090165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/31/2022] [Indexed: 12/13/2022] Open
Abstract
Lymphoepithelial carcinoma (LEC) of the oral mucosa is a rare histopathologic subtype of squamous cell carcinoma (SCC), which shares morphologic similarities with nasopharyngeal carcinoma (NPC), non-keratinizing undifferentiated subtype. The admixture of neoplastic epithelial tumor cells and a dense lymphoplasmacytic infiltrate makes microscopic diagnosis challenging. LEC etiopathogenesis has been variably associated with Epstein–Barr virus (EBV) infection, depending on the specific anatomic location and racial predilection, with a higher incidence in endemic populations. Although described in several subsites of the head and neck region, including the major salivary glands, the oral mucosa is considered an infrequent location for LEC development, deriving either from minor salivary glands (MSGs) or the surface epithelium. Herein, we report a rare case of an EBV-negative LEC arising from the oral surface epithelium, presenting as gingival swelling, and review the pertinent English-language literature, which revealed only 26 previously reported oral LECs. Our case is only the fourth oral LEC originating from the surface epithelium and the first one to affect the gingiva.
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Zhang M, Ye J, Li H, Huang P, Chen J, Lin F, Xiao M. Imaging Features of Lymphoepithelial-Like Carcinoma of the Salivary Glands. EAR, NOSE & THROAT JOURNAL 2022:1455613221116330. [PMID: 35848422 DOI: 10.1177/01455613221116330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Lymphoepithelial-like carcinoma of the salivary glands (LELCSG) is a rare tumour of unknown aetiology. No studies have reported the imaging features of primary LELCSG. METHODS The clinical information and imaging features of eight patients with LELCSG were reviewed. Computed tomography (n = 4 patients) and magnetic resonance imaging (n = 4 patients) features were analysed by two radiologists to identify the location, number, size, shape, boundary, signal intensity and enhancement of LELCSG. RESULTS The study included four women and four men, and the mean size of the tumours was 32.88 ± 3.41 mm (range, 27-38 mm). The tumours affected the parotid gland in six cases and the submandibular gland in two cases. The eight cases were evaluated by radiologists. All tumours were lobulated; three had clear edges and five had blurred edges. There was no necrosis in six tumours, while two tumours exhibited slight necrosis without bleeding. All eight tumours showed multiple nodular changes and extensive fusion. Four tumours with magnetic resonance imaging (MRI) were isointense or slightly hyperintense on T1-weighted imaging (T1WI) and obvious homogeneous enhancement on contrasted enhanced T1WI scan, while slightly hyperintense on T2-weighted imaging (T2WI). The other four lesions were isodense on computed tomography (CT) scan. The degree of enhancement varied among the eight tumours. The necrotic zones of the eight tumours did not exhibit any enhancement. CONCLUSIONS LELCSG is a lobulated, multi-nodular tumour, with some fused nodules. LELCSG lesions showed isointensity or slight hyperintensity on T1WI MRI, slight hyperintensity on T2WI MRI and isodense on CT scan. Larger tumours may exhibit some necrosis, but the necrotic cysts were relatively rare. Uniform enhancement was observed in non-necrotic areas on enhanced CT and MRI scan. The multi-nodular feature may be valuable for diagnosis.
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Affiliation(s)
- Meng Zhang
- Zhuhai Hospital, Guangdong Province Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Jingzhi Ye
- Zhuhai Hospital, Guangdong Province Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Hongyi Li
- Zhuhai Hospital, Guangdong Province Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Peikai Huang
- Zhuhai Hospital, Guangdong Province Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Jun Chen
- Zhuhai Hospital, Guangdong Province Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Fenghuang Lin
- Zhuhai Hospital, Guangdong Province Hospital of Traditional Chinese Medicine, Zhuhai, China
| | - Mengqiang Xiao
- Zhuhai Hospital, Guangdong Province Hospital of Traditional Chinese Medicine, Zhuhai, China
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Niu X, Liu P, Zhou X, Wang X, Hu C. Is postoperative radiotherapy an essential treatment for nonmetastatic lymphoepithelial carcinoma of the salivary gland? Radiother Oncol 2022; 172:76-82. [PMID: 35568285 DOI: 10.1016/j.radonc.2022.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/02/2022] [Accepted: 05/08/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Lymphoepithelial carcinoma of salivary gland (LECSG) is a rare malignant tumor. Whether postoperative radiotherapy (PORT) can improve locoregional control and which patients can benefit from PORT are unknown. This study aimed to evaluate the role of PORT and provide individualized suggestions for postoperative therapy in patients with LECSG. PATIENTS AND METHODS We retrospectively reviewed patients with nonmetastatic LECSG who underwent surgery with or without PORT. Recursive partitioning analysis (RPA) was performed to categorize the patients and predict progression-free survival (PFS). RESULTS A total of 223 patients were included, 34 (15.2%) received surgery alone, whereas the remaining 189 (84.8%) underwent PORT in the initial treatment. Although patients in the PORT group were with advanced T stage and N stage, the PORT group had an advantage over the non-PORT group on 1-year, 5-year and 10-year PFS and locoregional control (LRC). PORT was an independent prognostic factor for PFS and LRC. Furthermore, compared with T stage and N stage, the size of the primary tumor and the number of positive lymph nodes were better prognostic predictors. The RPA model was generated according to the endpoint of PFS and categorized patients into 3 prognostic groups: low-risk (maximum diameter of primary lesion (≤3cm) and number of positive lymph nodes (≤2)), intermediate-risk (maximum diameter of primary lesion (>3cm) and number of positive lymph nodes (≤2)), and high-risk (number of positive lymph nodes (>2)), with corresponding 5-year PFS rates of 90.0%, 75.0%, and 51.0%, respectively. Significant improvement in PFS was observed in the PORT group among intermediate-risk (P=0.000) and high-risk patients (P=0.000). CONCLUSIONS PORT was shown to be a positive prognostic factor for PFS and LRC of LECSG. PORT was an essential treatment especially for patients with >3cm maximum diameter of primary lesion and/or >2 positive lymph nodes.
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Affiliation(s)
- Xiaoshuang Niu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Peiyao Liu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Xin Zhou
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Xiaoshen Wang
- Department of Radiation Oncology, Eye and ENT Hospital, Fudan University, Shanghai, China.
| | - Chaosu Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Radiation Oncology, Shanghai, China.
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Primary Lymphoepithelioma-Like Carcinoma of the Conjunctiva Metastatic to Regional Lymph Nodes and Parotid Gland in a Mexican Patient. Case Rep Ophthalmol Med 2022; 2022:9265244. [PMID: 35198254 PMCID: PMC8860538 DOI: 10.1155/2022/9265244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/06/2022] [Accepted: 01/20/2022] [Indexed: 12/04/2022] Open
Abstract
Lymphoepithelioma-like carcinoma (LELC) of the conjunctiva is a rare malignancy in the ocular adnexa. There are no prospective data regarding treatment methods. Complete surgical excision is sufficient in the majority of cases. Radiation therapy is sometimes used in case of recurrence or positive margins after surgery. This case describes an 89-year-old Hispanic female with a 7-month history tumor primarily located on the left lower palpebral conjunctiva. The patient underwent an excisional biopsy of the tumor, and histopathology exam reported an LELC with positive margins. She developed parotid and neck lymph node metastasis treated with concurrent radiotherapy. The patient had remained disease-free for 3 years. According to the available data, there are only five cases of LELC reported in conjunctiva worldwide, so this report increases the differential diagnoses of tumors in the ocular adnexa and supports the effectiveness of radiotherapy.
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Zou WQ, Luo WJ, Feng YF, Liu F, Liang SB, Fang XL, Liang YL, Liu N, Wang YQ, Mao YP. Expression Profiles and Prognostic Value of Multiple Inhibitory Checkpoints in Head and Neck Lymphoepithelioma-Like Carcinoma. Front Immunol 2022; 13:818411. [PMID: 35140722 PMCID: PMC8818848 DOI: 10.3389/fimmu.2022.818411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundInhibitory checkpoints are promising antitumor targets and predictive biomarkers in a variety of cancers. We aimed to identify the expression levels and prognostic value of multiple inhibitory checkpoints supported by preclinical and clinical evidence in head and neck lymphoepithelioma-like carcinoma (HNLELC).MethodsThe expression of seven inhibitory checkpoints were evaluated in the tumor nest (TN) and tumor stroma (TS) of 102 HNLELC specimens using immunohistochemistry and digital pathology, and an inhibitory checkpoint-based signature (ICS) was subsequently constructed using the LASSO Cox regression model.ResultsPD-L1, B7H3, and IDO-1 were mostly expressed in the TN, with median H-score of TN vs TS: 63.6 vs 14.6; 8.1 vs 1.0; 61.5 vs 34.7 (all P < 0.001), whereas PD-1, TIM-3, LAG-3, and VISTA were mainly observed in the TS, with median H-score of TN vs TS: 0.2 vs 12.4, 3.4 vs 7.1, 6.2 vs 11.9, 16.4 vs 47.2 (all P < 0.001), respectively. The most common simultaneously expressed combinations consisted of PD-L1 + B7H3 + IDO-1 + TIM-3 + LAG-3 + VISTA and B7H3 + IDO-1 + TIM-3 + LAG-3 in the TN (both occurring in 8.8% of patients) and PD-L1 + B7H3 + IDO-1 in the TS (4.9%). In addition, high-ICS patients had shorter 5-year disease-free (40.6% vs 81.7%; P < 0.001), regional recurrence-free (63.5% vs 88.2%; P = 0.003), and overall survival (73.5% vs 92.9%; P = 0.006) than low-ICS patients. Multivariate analysis revealed that ICS represented an independent predictor, which could significantly complement the predictive performance of TNM stage for 3-year (AUC 0.724 vs 0.619, P = 0.014), 5-year (AUC 0.727 vs 0.640, P = 0.056), and 10-year disease-free survival (AUC 0.815 vs 0.709, P = 0.023).ConclusionsThe expression of inhibitory checkpoints and ICS classifier may increase the prognostic value of the TNM staging system and guide the rational design of personalized inhibitory checkpoint blockade therapy in HNLELC.
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Affiliation(s)
- Wen-Qing Zou
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Wei-Jie Luo
- Department of Medical Oncology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Yan-Fen Feng
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Fang Liu
- Department of Pathology, The First People’s Hospital of Foshan, Foshan, China
| | - Shao-Bo Liang
- Department of Radiation Oncology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xue-Liang Fang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Ye-Lin Liang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
| | - Na Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
- *Correspondence: Yan-Ping Mao, ; Ya-Qin Wang, ; Na Liu,
| | - Ya-Qin Wang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
- *Correspondence: Yan-Ping Mao, ; Ya-Qin Wang, ; Na Liu,
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China
- *Correspondence: Yan-Ping Mao, ; Ya-Qin Wang, ; Na Liu,
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Lymphoepithelial carcinoma of the submandibular gland in a Japanese woman: A case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2021. [DOI: 10.1016/j.ajoms.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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12
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Clinical analysis of 12 patients with primary lymphoepithelial carcinoma of the parotid gland. Eur Arch Otorhinolaryngol 2021; 279:2003-2008. [PMID: 34379180 DOI: 10.1007/s00405-021-06947-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 06/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND PURPOSE The WHO recently designated salivary gland lymphoepithelial carcinoma as a unique malignant tumor that most commonly occurs in the parotid gland. This is a rare cancer and there are few reports in the literature. Among 854 patients with parotid gland tumors who were admitted to our institution, we diagnosed 12 patients (1.41%) with parotid lymphoepithelial carcinoma. METHODS Retrospective analysis of 12 patients with parotid lymphoepithelial carcinoma diagnosed by the Department of Pathology, Xiangya Hospital of Central South University. RESULTS All 12 patients had unilateral parotid gland disease and 8 had cervical lymph node metastasis. Five patients received PCR testing for the Epstein-Barr virus and two were positive. All patients received surgical treatment, two received surgical resection alone, nine received surgery and postoperative radiotherapy and chemotherapy, and one received surgery and postoperative chemotherapy. The postoperative follow-up time ranged from 13 to 77 months. As of the last follow-up, eight patients were tumor-free, one patient was lost to follow-up, and three patients died. The main cause of death was local tumor recurrence and multiple metastases throughout the body. CONCLUSION Parotid lymphoepithelial carcinoma is a malignant neoplasm characterized by proliferation, invasion, and inclusion of poorly differentiated or undifferentiated carcinoma, and a high rate of metastasis to ipsilateral cervical lymph nodes. The comprehensive treatment method consists of radical resection combined with postoperative radiotherapy and chemotherapy. After this comprehensive treatment, the 1-year, 3-year, and 5-year overall survival rates of our patients were 100%, 78.8%, and 39.4%.
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Galletti C, Pizzimenti C, Cavallari V, Galletti B. Larynx lymphoepithelial carcinoma: surgical management. BMJ Case Rep 2021; 14:14/7/e241460. [PMID: 34285018 DOI: 10.1136/bcr-2020-241460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Lymphoepithelial carcinoma (LEC) is an entity mostly frequent in the nasopharynx, which represents 40% of all neoplasms. The incidence's not exclusive of a geographic area; however, it has an endemic distribution in Southeast Asia and Eskimos. LEC is not exclusive of the nasopharynx, has also been reported in other anatomical areas, such as the sinonasal tract, nasolacrimal duct, oral cavity, oropharynx, salivary glands, thymus, hypopharynx, oesophagus, stomach, trachea, lung and others. Non-nasopharyngeal and nasopharyngeal LEC have the same microscopic features, but the nasopharyngeal is more likely associated with Epstein-Barr virus. LEC has been approved by the WHO. LEC located in the larynx is quite rare and worthy of attention for its implication in the treatment and prognosis. We present a case of LEC treated in our ENT department in a middle-aged man.
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Affiliation(s)
- Cosimo Galletti
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | | | | | - Bruno Galletti
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
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Takeda D, Shigeoka M, Sugano T, Yatagai N, Hasegawa T, Akashi M. A Case Report of Tongue Lymphoepithelial Carcinoma with a Histological Diagnostic Dilemma. Diagnostics (Basel) 2021; 11:diagnostics11061039. [PMID: 34200073 PMCID: PMC8229143 DOI: 10.3390/diagnostics11061039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022] Open
Abstract
Most head and neck lymphoepithelial carcinomas (LECs) arise in the nasopharynx and harbor Epstein–Barr virus (EBV). LEC is also a rare subtype of the oral squamous cell carcinoma (SCC). Morphologically, LEC is defined as resembling non-keratinizing nasopharyngeal carcinoma, undifferentiated subtype. The histological features and pathogenesis of oral LEC are not established. We describe a case of tongue LEC with histopathological diagnostic difficulties. A 72-year-old Japanese female presented with a whitish change on her left-side tongue. The diagnosis was atypical epithelium; neoplastic change could not be ruled out by a biopsy. Although the lesion was monitored at our hospital per her request, invasive carcinoma was detected 11 months later. Microscopically, conventional SCC was observed with the characteristic features as LEC confined to the deep part of the lesion. We briefly discuss this unusual histological finding and make a novel proposal for distinguishing oral LEC from LECs in other regions based on these histological findings.
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Affiliation(s)
- Daisuke Takeda
- Division of Oral and Maxillofacial Surgery, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (D.T.); (N.Y.); (T.H.); (M.A.)
| | - Manabu Shigeoka
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
- Correspondence: ; Tel.: +81-78-382-5465; Fax: +81-78-382-5479
| | - Tenyu Sugano
- Division of Diagnostic Pathology, Department of Pathology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan;
| | - Nanae Yatagai
- Division of Oral and Maxillofacial Surgery, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (D.T.); (N.Y.); (T.H.); (M.A.)
| | - Takumi Hasegawa
- Division of Oral and Maxillofacial Surgery, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (D.T.); (N.Y.); (T.H.); (M.A.)
| | - Masaya Akashi
- Division of Oral and Maxillofacial Surgery, Department of Surgery Related, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (D.T.); (N.Y.); (T.H.); (M.A.)
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15
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Almeida LY, Silveira HA, Silva EV, Barbeiro CDO, de Paula JA, Bufalino A, Ribeiro-Silva A, León JE. EBV-negative lymphoepithelial-like carcinoma of the lower lip. AUTOPSY AND CASE REPORTS 2019; 10:e2020138. [PMID: 32039067 PMCID: PMC6945326 DOI: 10.4322/acr.2020.138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 11/14/2019] [Indexed: 12/31/2022] Open
Abstract
Lymphoepithelial-like carcinoma (LEC) is a rare malignant neoplasm, which can be associated with Epstein-Barr virus (EBV) infection. Histologically, LEC is an undifferentiated carcinoma with an intermixed reactive lymphoplasmacytic infiltrate. LEC appears to be an uncommon tumor type of lip carcinoma. An 82-year-old white woman presented a lesion on her lower lip that developed over the last year. The lesion was characterized by ulceration with flat edges, hardened base, painful, and absence of regional lymphadenopathy. Microscopical analysis evidenced an intense inflammatory infiltrate, composed of lymphoplasmacytic cells, associated with scarce pleomorphic epithelial cells. Immunohistochemistry highlighted the LEC cells with strong expression of pan-CK AE1/AE3, EMA, p63, and p53. CD138 was also faintly positive. Ki-67 was >85%. In situ hybridization analysis did not show evidence of EBV. A diagnostic of EBV-negative LEC was made. We present an uncommon type of lip carcinoma, which can represent a diagnostic challenge for clinicians and pathologists.
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Affiliation(s)
- Luciana Yamamoto Almeida
- Universidade Estadual de São Paulo (Unesp), Faculdade de Odontologia de Araraquara, Medicina Oral, Departamento de Diagnóstico e Cirurgia. Araraquara, SP, Brasil
| | - Heitor Albergoni Silveira
- Universidade Estadual de São Paulo (Unesp), Faculdade de Odontologia de Araraquara, Medicina Oral, Departamento de Diagnóstico e Cirurgia. Araraquara, SP, Brasil.,Universidade de São Paulo (USP), Faculdade de Odontologia de Ribeirão Preto, Patologia Oral, Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal. Ribeirão Pareto, SP, Brasil
| | - Evânio Vilela Silva
- Universidade Estadual de São Paulo (Unesp), Faculdade de Odontologia de Araraquara, Medicina Oral, Departamento de Diagnóstico e Cirurgia. Araraquara, SP, Brasil.,Universidade de São Paulo (USP), Faculdade de Odontologia de Ribeirão Preto, Patologia Oral, Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal. Ribeirão Pareto, SP, Brasil
| | - Camila de Oliveira Barbeiro
- Universidade Estadual de São Paulo (Unesp), Faculdade de Odontologia de Araraquara, Medicina Oral, Departamento de Diagnóstico e Cirurgia. Araraquara, SP, Brasil
| | - Joaquim Augusto de Paula
- Dentista, Estratégia Saúde da Família, Ministério da Saúde do Brasil. Ribeirão Pareto, SP, Brasil
| | - Andreia Bufalino
- Universidade Estadual de São Paulo (Unesp), Faculdade de Odontologia de Araraquara, Medicina Oral, Departamento de Diagnóstico e Cirurgia. Araraquara, SP, Brasil
| | - Alfredo Ribeiro-Silva
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Patologia e Medicina Legal. Ribeirão Preto, SP, Brasil
| | - Jorge Esquiche León
- Universidade de São Paulo (USP), Faculdade de Odontologia de Ribeirão Preto, Patologia Oral, Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal. Ribeirão Pareto, SP, Brasil
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Monteiro F, Baldaia H, Ribeiro L, Sousa M, Oliveira P, Ferreira E, de Almeida MG, Condé A. Epstein-Barr Virus-Associated With Lymphoepithelial Carcinoma: A Rare Tumor of the Larynx. CLINICAL MEDICINE INSIGHTS. EAR, NOSE AND THROAT 2019; 12:1179550619865551. [PMID: 31427858 PMCID: PMC6683599 DOI: 10.1177/1179550619865551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 12/19/2022]
Abstract
Lymphoepithelial carcinoma of the larynx is a rare tumor, as this histological entity is mostly diagnosed in nasopharynx. However, it may be present in other non-nasopharyngeal sites and it is extremely rare in the larynx. The authors present a case of a 59-year-old man who presented to the Otorhinolaryngology-Head and Neck Surgery Department complaining of a long-standing dysphonia, odynophagia, and dysphagia. The clinical examination revealed a laryngeal tumor involving the right epiglottis, right aryepiglottic fold, and ipsilateral false vocal fold. It presented with ispilateral neck lymph node extension. Multiple biopsies of the laryngeal lesion were performed under local anesthesia and the histological examination showed a poorly differentiated squamous cell carcinoma. After discussing the case in a multidisciplinary tumor board, a total laryngectomy with a bilateral neck dissection was performed and the histological specimen showed a lymphoepithelial carcinoma. Although immunostaining with LMP-1 antibody was negative, in situ hybridization for Epstein-Barr virus was positive. He underwent adjuvant chemoradiation. He is now at 9-months follow-up period, with no evidence of disease. Lymphoepithelial carcinoma of the larynx is an extremely rare disease, with an aggressive pattern. Epstein-Barr virus-associated lymphoepithelial carcinoma has been exceptionally reported. A correct diagnosis and close collaboration with pathologist is crucial to achieve the best treatment strategy. We present this case to discuss the clinical and histology findings and the different therapeutic aspects of this uncommon histological subtype carcinoma.
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Affiliation(s)
- Francisco Monteiro
- Department of Otorhinolaryngology-Head and Neck Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Helena Baldaia
- Department of Pathology, LAP-Laboratório de Anatomia Patológica, Porto, Portugal
| | - Leandro Ribeiro
- Department of Otorhinolaryngology-Head and Neck Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Manuel Sousa
- Department of Otorhinolaryngology-Head and Neck Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Pedro Oliveira
- Department of Otorhinolaryngology-Head and Neck Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Edite Ferreira
- Department of Otorhinolaryngology-Head and Neck Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Mário Giesteira de Almeida
- Department of Otorhinolaryngology-Head and Neck Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Artur Condé
- Department of Otorhinolaryngology-Head and Neck Surgery, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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17
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Luo WJ, Feng YF, Guo R, Tang LL, Chen L, Zhou GQ, Li WF, Liu X, Sun Y, Lin AH, Ma J, Mao YP. Patterns of EBV-positive cervical lymph node involvement in head and neck cancer and implications for the management of nasopharyngeal carcinoma T0 classification. Oral Oncol 2019; 91:7-12. [PMID: 30926066 DOI: 10.1016/j.oraloncology.2019.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/17/2019] [Accepted: 01/19/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Epstein-Barr virus (EBV)-positive cervical lymph node (CLN) metastasis of unknown primary origin is classified as nasopharyngeal carcinoma (NPC) T0 by the American Joint Committee on Cancer staging manual (8th edition). We aimed to investigate the possible primary sites and patterns of EBV-positive CLN metastases and to provide implications for the management of NPC T0 classification. MATERIALS AND METHODS We retrospectively reviewed 269 patients with newly diagnosed EBV-positive CLN metastatic disease who underwent EBV detection via EBV-encoded RNA in situ hybridization. Fifteen patients with unknown primary tumors underwent follow-up after initial treatment. RESULTS In patients with EBV-positive CLNs, the most common primary sites after the nasopharynx (51.7%) were the salivary gland (24.5%), lung (7.8%), oropharynx (3.3%), nasal cavity/maxillary (3.3%), oral cavity (2.2%), orbit (1.1%), and liver (0.4%). No primary site was found in 15 patients (5.6%). For salivary gland malignancies, level II and I were the most frequently involved regions. Tumors arising from the lung or liver metastasized to the lower neck (level IV, V, and VI) rather than the upper neck. After initial treatment, 2/15 patients with EBV-positive CLNs of unknown primary exhibited primary NPC and oropharyngeal tumor, respectively. Further, even without prophylactic irradiation to the nasopharynx, only one of 13 unknown primary patients developed NPC. CONCLUSIONS The origins of EBV-positive CLNs may not be restricted to the nasopharynx alone, and are likely to involve the head and neck or non-head and neck regions. NPC T0 classification should be cautiously assigned to such tumors.
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Affiliation(s)
- Wei-Jie Luo
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Yan-Fen Feng
- Department of Pathology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Rui Guo
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Ling-Long Tang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Lei Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Guan-Qun Zhou
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Wen-Fei Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Xu Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Ying Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China
| | - Ai-Hua Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Jun Ma
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China.
| | - Yan-Ping Mao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China.
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Takakura H, Tachino H, Fujisaka M, Nakajima T, Yamagishi K, Ishida M, Shojaku H. Lymphoepithelial carcinoma of the maxillary sinus: A case report and review of the literature. Medicine (Baltimore) 2018; 97:e11371. [PMID: 29995775 PMCID: PMC6076030 DOI: 10.1097/md.0000000000011371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Most cases of lymphoepithelial carcinoma (LEC) occur in the nasopharynx, and LEC in the sinonasal tract is extremely rare; thus, the clinical characteristics of sinonasal LEC are not well known. PATIENT CONCERNS A 63-year-old Japanese man presented with a three-week history of left cheek pain, nasal obstruction and cheek swelling. DIAGNOSES Enhanced CT and MRI revealed a tumor of the left maxillary sinus that invaded the left orbit and hard palate, with multiple swollen left cervical lymph nodes. Open biopsy was performed, and the specimen was diagnosed as LEC. INTERVENTIONS Alternating chemoradiotherapy (ALCRT) followed by salvage surgery was performed. OUTCOMES Our patient has been disease free for 5 years. LESSONS A literature review of the epidemiology, etiology, clinical course and management of sinonasal LEC is highlighted. We believe ALCRT followed by salvage surgery to be a highly optimal treatment for sinonasal LEC from the viewpoint of a balance between quality of life and a high curative effect.
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Affiliation(s)
| | | | | | | | - Kentaro Yamagishi
- Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | | | - Hideo Shojaku
- Department of Otorhinolaryngology, Head and Neck Surgery
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Tan E, Mody MD, Saba NF. Systemic therapy in non-conventional cancers of the larynx. Oral Oncol 2018; 82:61-68. [DOI: 10.1016/j.oraloncology.2018.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/05/2018] [Accepted: 05/10/2018] [Indexed: 12/11/2022]
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20
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Lymphoepithelial Carcinoma of the Nasolacrimal Duct: Clinical, Radiologic, and Immunopathologic Features. Ophthalmic Plast Reconstr Surg 2017; 33:S18-S21. [DOI: 10.1097/iop.0000000000000478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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López F, Williams MD, Cardesa A, Hunt JL, Strojan P, Rinaldo A, Nixon IJ, Rodrigo JP, Saba NF, Mendenhall WM, Quer M, Suárez C, Ferlito A. How phenotype guides management of non-conventional squamous cell carcinomas of the larynx? Eur Arch Otorhinolaryngol 2017; 274:2709-2726. [PMID: 28364287 DOI: 10.1007/s00405-017-4533-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 03/13/2017] [Indexed: 12/15/2022]
Abstract
Although the majority of laryngeal malignancies are the conventional squamous cell carcinomas (SCC), a wide variety of malignant epithelial tumors can affect the larynx. Current treatment guidelines are designed to guide clinicians in management of conventional laryngeal SCC. Less is known about the biological behavior and responsiveness to therapy and overall outcomes of other malignant epithelial lesions. Because a spectrum of disease biology is represented by these rare phenotypes, an understanding of the basic biology can help direct management to optimize clinical outcome in this group of patients. This review provides a critical analysis of literature relating to the diagnosis, management, and outcome of patients with non-conventional squamous malignant epithelial neoplasms of the larynx. Particular attention is paid to features which are at variance with the conventional SCC and how these impact on management of these rare tumors.
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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 33011, Oviedo (Asturias), Spain. .,Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain.
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Antonio Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | | | - Iain J Nixon
- Departments of Surgery and Otolaryngology, Head and Neck Surgery, Edinburgh University, Edinburgh, UK
| | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Avenida de Roma s/n, 33011, Oviedo (Asturias), Spain.,Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain
| | - Nabil F Saba
- Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | | | - Miquel Quer
- Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Carlos Suárez
- Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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22
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Distribution of lymph node metastasis from lymphoepithelial-like carcinoma of the parotid. Oncotarget 2016; 8:84841-84846. [PMID: 29156687 PMCID: PMC5689577 DOI: 10.18632/oncotarget.11002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Accepted: 06/29/2016] [Indexed: 12/05/2022] Open
Abstract
Purpose To explore the distribution of node spread from lymphoepithelial-like carcinoma (LELC) of the parotid gland based on the 2013 updated guidelines for neck node levels. Results 42 (58.3%) cases had metastatic nodes, all were localized at the ipsilateral neck. The detailed distribution was: level Ia 0, level Ib 6(14.3%), level II 34 (80.1%), level III 16 (38.1%), level IV 9 (21.4%), level V 7 (16.7%), level VI 0, level VII 0, level VIII 37 (88.1%), level IX 0, level Xa 2 (4.8%), and level Xb 0. Lymphadenopathy in level Ib, V and Xa was always accompanied with level II or level VIII nodal metastasis. No statistical significance was found in the incidence of nodal involvement between T1-2 and T3-4 tumors (57.4% versus 61.1%, p = 0.78). Methods We retrospectively reviewed the surgical and imaging documents of 72 cases of LELC from the parotid gland between January 2004 and November 2015. All patients received contrast enhanced computed tomography (CT) or magnetic resonance imaging (MRI). Parotid metastasis from nasopharyngeal cancer (NPC) was excluded. Nodal status and distribution was evaluated by both pathologic reports and imaging studies. Conclusions This is the first description of topography of cervical nodal metastases from LELC of the parotid gland. Incidence of nodal involvement is high. Nodes at ipsilateral level VIII and II were most frequently involved, followed by level III, IV, V and Ib. Nodes in level Ia, VI and level VII were rarely seen.
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Lymphoepithelial Carcinoma of the Sublingual Gland: Case Report and Review of the Literature. J Oral Maxillofac Surg 2015; 73:1878.e1-5. [DOI: 10.1016/j.joms.2015.04.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/15/2015] [Accepted: 04/21/2015] [Indexed: 11/21/2022]
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24
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Chan JYK, Wong EWY, Ng SK, Vlantis AC. Non-nasopharyngeal head and neck lymphoepithelioma-like carcinoma in the United States: A population-based study. Head Neck 2015; 38 Suppl 1:E1294-300. [DOI: 10.1002/hed.24215] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 06/25/2015] [Accepted: 07/10/2015] [Indexed: 01/10/2023] Open
Affiliation(s)
- Jason Y. K. Chan
- Department of Otorhinolaryngology; Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong; Hong Kong SAR
| | - Eddy W. Y. Wong
- Department of Otorhinolaryngology; Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong; Hong Kong SAR
| | - Siu-Kwan Ng
- Department of Otorhinolaryngology; Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong; Hong Kong SAR
| | - Alexander C. Vlantis
- Department of Otorhinolaryngology; Head and Neck Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong; Hong Kong SAR
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25
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Kermani W, Belcadhi M, Sriha B, Abdelkéfi M. Epstein-Barr virus-associated lymphoepithelial carcinoma of the larynx. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:231-3. [PMID: 26043818 DOI: 10.1016/j.anorl.2015.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Lymphoepithelial carcinoma is a rare tumour, named after its histological resemblance to undifferentiated nasopharyngeal carcinoma. The pathogenesis of lymphoepithelial carcinoma remains unknown. This tumour has been described in several organs, but the larynx remains an exceptional site. CASE REPORT The authors report the case of a 73-year-old man who consulted for longstanding dysphonia and rapidly deteriorating dyspnoea requiring emergency tracheotomy. Endoscopic examination demonstrated a tumour of the left hemilarynx with fixed vocal cords. Histological examination and immunohistochemistry demonstrated lymphoepithelial carcinoma of the larynx. Screening for Epstein-Barr Virus (EBV) by immunohistochemistry and in situ hybridization was positive. Treatment consisting of neoadjuvant chemotherapy followed by surgical resection and then external beam radiotherapy achieved cure with a follow-up of 18months since completion of treatment. DISCUSSION Lymphoepithelial carcinoma of the larynx is rare. Immunohistochemical examination is essential for the positive diagnosis. Epstein-Barr virus-associated lymphoepithelial carcinoma has been exceptionally reported. The radiosensitivity of this tumour allows conservative first-line treatment.
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Affiliation(s)
- Wassim Kermani
- Service d'ORL, CHU Farhat Hached, avenue Ibn Eljazzar, 4000 Sousse, Tunisia.
| | - Malek Belcadhi
- Service d'ORL, CHU Farhat Hached, avenue Ibn Eljazzar, 4000 Sousse, Tunisia
| | - Badreddine Sriha
- Laboratoire d'anatomie et de cytologie pathologiques, CHU Farhat Hached, avenue Ibn Eljazzar, 4000 Sousse, Tunisia
| | - Mouhamed Abdelkéfi
- Service d'ORL, CHU Farhat Hached, avenue Ibn Eljazzar, 4000 Sousse, Tunisia
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26
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Rahmati R, Dogan S, Pyke O, Palmer F, Awad M, Lee N, Kraus DH, Shah JP, Patel SG, Ganly I. Squamous cell carcinoma of the tonsil managed by conventional surgery and postoperative radiation. Head Neck 2014; 37:800-7. [PMID: 24616252 DOI: 10.1002/hed.23679] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 01/09/2014] [Accepted: 03/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to report the long-term outcome of patients with squamous cell cancer (SCC) of the tonsil managed by surgery followed by postoperative radiotherapy (PORT). METHODS Eighty-eight patients treated between 1985 and 2005 were analyzed. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were determined by the Kaplan-Meier method. Factors predictive of outcome were determined by univariate and multivariate analysis. RESULTS Forty-eight percent of patients had T3 to T4 disease and 75% had a positive neck. Five-year OS, DSS, and RFS were 66%, 82%, and 80%, respectively. The status of the neck was not predictive of outcome (DSS 80% for N0 vs 82% for N+; p = .97). Lymphovascular invasion was an independent predictor of OS, DSS, and RFS on multivariate analysis. CONCLUSION Lymphovascular invasion but not pathological stage of the neck is an independent predictor of outcome in patients with tonsillar SCC.
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Affiliation(s)
- Rahmatullah Rahmati
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York, New York
| | - Snjezana Dogan
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Owen Pyke
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.,State University of New York - Stony Brook, School of Medicine, Stony Brook, New York
| | - Frank Palmer
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Mahmoud Awad
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Dennis H Kraus
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York.,Head and Neck Institute, North Shore Health System, Great Neck, New York
| | - Jatin P Shah
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Snehal G Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Ian Ganly
- Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
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27
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A clinical analysis of 37 cases with lymphoepithelial carcinoma of the major salivary gland treated by surgical resection and postoperative radiotherapy: a single institution study. Med Oncol 2014; 31:957. [DOI: 10.1007/s12032-014-0957-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/31/2014] [Indexed: 11/30/2022]
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28
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Lymphoepithelial Carcinoma—Review of the Treatment Modalities and Report of a Rare Case in the Sublingual Gland. J Oral Maxillofac Surg 2014; 72:823-8. [DOI: 10.1016/j.joms.2013.10.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 10/05/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
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29
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Pegolo E, Parodi P, Francescon M, Di Loreto C. A rare case of undifferentiated nonkeratinizing carcinoma of the lip mucosa. J Oral Maxillofac Surg 2014; 72:1119-23. [PMID: 24576436 DOI: 10.1016/j.joms.2013.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 12/08/2013] [Accepted: 12/13/2013] [Indexed: 11/16/2022]
Abstract
Undifferentiated nonkeratinizing carcinoma (UNC) is a poorly differentiated squamous cell carcinoma accompanied by a prominent reactive lymphoplasmacytic infiltrate that can occur in many anatomic sites. It shares morphologic features with undifferentiated nonkeratinizing nasopharyngeal carcinoma, in which a strong association with Epstein-Barr virus (EBV) has been noted. Among UNCs arising outside the nasopharynx, the linkage with EBV is variable; in particular, the few cases of UNC of the lip described thus far have been negative for EBV. This report describes a rare case of primary UNC of the lower lip mucosa in a 73-year-old man in whom molecular analysis for EBV showed some amount of viral DNA within the tumor. Surgical excision without adjuvant treatment was performed and the patient was alive without recurrence after 42 months of follow-up. This report presents a rare localization of UNC possibly related to EBV infection and with a good clinical outcome.
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Affiliation(s)
- Enrico Pegolo
- Medical Doctor, Department of Medical and Biological Sciences, Institution of Anatomic Pathology, Azienda Ospedaliero Universitaria S Maria della Misericordia, Udine, Italy.
| | - Piercamillo Parodi
- Associate Professor of Plastic and Reconstructive Surgery, Department of Experimental and Clinical Medical Sciences, Institution of Plastic and Reconstructive Surgery, Azienda Ospedaliero Universitaria S Maria della Misericordia, Udine, Italy
| | - Michela Francescon
- Medical Doctor, Department of Experimental and Clinical Medical Sciences, Institution of Plastic and Reconstructive Surgery, Azienda Ospedaliero Universitaria S Maria della Misericordia, Udine, Italy
| | - Carla Di Loreto
- Full Professor of Anatomic Pathology, Department of Medical and Biological Sciences, Institution of Anatomic Pathology, Azienda Ospedaliero Universitaria S Maria della Misericordia, Udine, Italy
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30
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Ma H, Lin Y, Wang L, Rao H, Xu G, He Y, Liang Y. Primary lymphoepithelioma-like carcinoma of salivary gland: sixty-nine cases with long-term follow-up. Head Neck 2014; 36:1305-12. [PMID: 23966284 DOI: 10.1002/hed.23450] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 03/11/2013] [Accepted: 08/12/2013] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lymphoepithelioma-like carcinoma (LELC) in the salivary glands is a rare but unique malignancy. METHODS Sixty-nine patients with salivary gland LELC with long-term follow-up were reviewed for this study. RESULTS There were 52 cases in the parotid gland and 17 cases in the submandibular gland. All patients underwent complete tumor excision, 41 underwent neck dissection, and 39 received postoperative radiotherapy. The 5-year, 10-year, and 15-year overall survival (OS) rates were 90%, 75%, and 54%, respectively. Patients with higher neutrophil/lymphocyte ratio (NLR ≥ 4.0) and advanced stage (stage III and IV) had significantly poorer OS. Patients who received postoperative radiotherapy had significantly better relapse-free survival (RFS). In multivariate analysis, stage, NLR, and neck dissection were associated independently with OS, whereas stage and postoperative radiotherapy were associated independently with RFS. CONCLUSION Salivary gland LELC is a rare malignancy with a better prognosis that partially attributes to surgery with neck dissection and postoperative radiotherapy. Preoperative NLR is an independent prognostic factor.
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Affiliation(s)
- Huali Ma
- Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China; State Key Laboratory of Oncology in South China/Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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31
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Qiu B, Lin YB, Cai QQ, Hu YM, Wang DF, Lin ZD, Liang Y. Primary lymphoepithelioma-like carcinoma of ocular adnexa: clinicopathologic features and treatment. ACTA ACUST UNITED AC 2013; 20:e113-22. [PMID: 23559878 DOI: 10.3747/co.20.1289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND METHODS Lymphoepithelioma-like carcinoma (lelc) is a rare malignancy in ocular adnexa. Here, we report 4 patients with lelc and review 11 patients reported in the literature. Clinical profiles, association with Epstein-Barr virus (ebv), treatment, and outcomes are analyzed. RESULTS Lacrimal glands and the lacrimal drainage system, eyelid, and conjunctiva are potential primary sites for lelc. The tumours are characterized histologically by nests of undifferentiated malignant cells surrounded by lymphoid infiltrates. Infection with ebv was confirmed in lelc of ocular adnexa, and that association seemed to be restricted to Asian populations. Results from our centre uniformly showed expression of ebv-encoded small rnas in primary tumour, locally recurrent tumour, and metastatic lymph nodes. This disease had a tendency to relapse regionally. Postoperative radiotherapy seems to improve disease-free survival. Tumours appear to be sensitive to radiotherapy and chemotherapy based on cisplatin and 5-fluorouracil. At our centre, 3 patients were still living at 22, 33, and 76 months after surgery. One patient died of distant metastasis after a survival of 38 months. CONCLUSIONS Lymphoepithelioma-like carcinoma is a heterogenous entity among ocular adnexal malignancies. Multimodality treatment provides a better chance at survival. Further investigation is required to achieve a better understanding of the biologic behavior of this entity and of its optimal treatment.
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Affiliation(s)
- B Qiu
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China
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32
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Mohammed D, Jaber A, Philippe M, Kishore S. Lymphoepithelial carcinoma in the maxillary sinus: a case report. J Med Case Rep 2012; 6:416. [PMID: 23231992 PMCID: PMC3522532 DOI: 10.1186/1752-1947-6-416] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 10/10/2012] [Indexed: 11/21/2022] Open
Abstract
Introduction Lymphoepithelial carcinoma of the maxillary sinus is a very rare malignancy and it can be difficult to make a pre-operative diagnosis. Case presentation A 72-year-old Caucasian woman presented to our facility with an isolated right-side epistaxis that had been present for three months, with the results of a computed tomography scan showing a soft tissue mass in the right maxillary sinus with an impacted tooth. The results of a transnasal endoscopic biopsy were compatible with a lymphoepithelial carcinoma, following which our patient underwent a radical excision of the mass. The final histology results revealed lymphoepithelial carcinoma of the maxillary sinus with negative assays for Epstein-Barr virus. Our patient was given post-operative external radiotherapy and has remained disease-free at three-year follow-up. Conclusions This report details the diagnosis and management of a case of lymphoepithelial carcinoma of the maxillary sinus, which is a very rare malignant tumor with very little mention in the literature. Only a strong suspicion with systematic use of various patho-immunological tests helps to arrive at a definitive diagnosis by excluding other better-known tumors.
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Affiliation(s)
- Darouichi Mohammed
- Department of ORL and Head and Neck surgery, CHUV, Lausanne, Switzerland.
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33
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Rytkönen AE, Hirvikoski PP, Salo TA. Lymphoepithelial carcinoma: two case reports and a systematic review of oral and sinonasal cases. Head Neck Pathol 2011; 5:327-34. [PMID: 21698444 PMCID: PMC3210216 DOI: 10.1007/s12105-011-0278-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 06/13/2011] [Indexed: 11/25/2022]
Abstract
Lymphoepithelial carcinoma (LEC) is a rare malignancy. Histologically, it is an undifferentiated carcinoma with an intermixed reactive lymphoplasmacytic infiltrate. Herein, we report two cases of LEC in the head and neck region that presented to Oulu University Hospital. Our first case is a 30-year-old man with LEC in the left maxillary sinus. The second case is a 49-year-old man with LEC in the soft palate and uvula with regional lymph node metastases at diagnosis. In addition, a systematic review of the literature from 1980 to 2010 was performed with MEDLINE and cross-references were searched manually. Case reports and clinical series of oral, oropharyngeal, nasal, and paranasal sinus LECs were reviewed revealing a total of 110 cases. Most of the oral cases were found in the tonsils (n = 29), oropharynx (n = 19), and in oral mucosa (n = 18), while sinonasal cases (n = 40) were mainly in the paranasal sinuses and nasal cavity. From 37 case reports, including ours, the median age was 58 and 62 years for sinonasal and oral/oropharyngeal LECs, respectively. Oral and oropharyngeal LECs have a 70.0% tendency to metastasize and 16.6% spread locally. In contrast, none of the nasal and paranasal LECs metastasized, but 60% spread locally. Epstein-Barr virus (EBV) had been detected in 87.5% of all tested LEC cases. Treatment of LECs, during the last decade, has largely consisted of surgery, combined with radiotherapy or chemoradiation. Although local spread or nodal metastases are fairly common at the time of diagnosis, the mortality rate of adequately treated LEC patients is low.
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Affiliation(s)
- Aleksi E. Rytkönen
- Department of Diagnostics and Oral Medicine, Institute of Dentistry, Oulu University Hospital, University of Oulu, PO Box 5281, 90014 Oulu, Finland
| | - Pasi P. Hirvikoski
- Department of Pathology, Oulu University Hospital, Oulu, Finland
- Länsi-Pohja Central Hospital, Kemi, Finland
| | - Tuula A. Salo
- Department of Diagnostics and Oral Medicine, Institute of Dentistry, Oulu University Hospital, University of Oulu, PO Box 5281, 90014 Oulu, Finland
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34
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Huon LK, Wang PC, Huang SH. Epstein Barr Virus–Associated Lymphoepithelial Carcinoma in the Middle Ear. Otolaryngol Head Neck Surg 2011; 144:296-7. [DOI: 10.1177/0194599810390479] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Leh-Kiong Huon
- Department of Otolaryngology, Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan
| | - Pa-Chun Wang
- Department of Otolaryngology, Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan
- School of Public Health, China Medical University, Taichung, Taiwan
| | - Shih-Hung Huang
- Department of Pathology, Cathay General Hospital, Taipei, Taiwan
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35
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Lymphoepithelioma-like carcinoma of the salivary gland: is radiotherapy alone adequate? Case Rep Otolaryngol 2011; 2011:618650. [PMID: 22937371 PMCID: PMC3420712 DOI: 10.1155/2011/618650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 09/11/2011] [Indexed: 11/23/2022] Open
Abstract
Introduction. Lymphoepithelioma-like carcinoma (LELC) of the salivary gland is a rare tumor. Currently, surgery with or without radiotherapy is the recommended treatment for all salivary gland carcinomas. However, in contrast to other high-grade salivary gland carcinomas, LELCs are considered radiosensitive. There are only a few published reports of radiotherapy alone for the treatment of salivary gland LELC. Case. We present two cases of LELC of the salivary gland. One was treated with surgery and postoperative radiotherapy, and the other was given a single cycle of chemotherapy and then radiotherapy. Currently, both patients have no evidence of disease. Conclusion. Radiotherapy as a single modality should be reevaluated. The role of systemic chemotherapy to gain systemic control should be addressed due to noteworthy metastatic disease.
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36
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Aurilio G, Ricci V, De Vita F, Fasano M, Fazio N, Orditura M, Funicelli L, De Luca G, Iasevoli D, Iovino F, Ciardiello F, Conzo G, Nolè F, Lamendola M. A possible connective tissue primary lymphoepithelioma-like carcinoma (LELC). Ecancermedicalscience 2010; 4:197. [PMID: 22276042 PMCID: PMC3234019 DOI: 10.3332/ecancer.2010.197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Indexed: 12/22/2022] Open
Abstract
Lymphoepithelial carcinoma is an undifferentiated nasopharyngeal carcinoma with lymphoid stroma and non-keratinizing squamous cells with distinctive clinical, epidemiological and etiological features. Conversely, lymphoepithelioma-like carcinomas (LELCs) are carcinomas that arise outside the nasopharynx but resemble a lymphoepithelioma histologically. In this case study, LELC presentation in connective tissue (left sternocleidomastoid muscle) is peculiar and unusual, but its diagnosis is supported by histological findings and clinical history, especially long disease free survival and no primary lesions in nasopharynx and lung district. We also discuss the pathogenesis, hypothesizing an embryological theory. To our knowledge, it could be the first reported case of a primary connective tissue LELC to the neck.
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Affiliation(s)
- G Aurilio
- Medical Care Unit, Department of Medical Oncology
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37
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Shet T, Arora B, Laskar S, Basak R, Kane S, Kurkure P. Epstein-barr virus-associated lymphoepithelioma-like carcinoma of mandible. Pediatr Dev Pathol 2009; 12:152-5. [PMID: 18457481 DOI: 10.2350/07-12-0395.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Accepted: 04/26/2008] [Indexed: 11/20/2022]
Abstract
We describe the first case of an lymphoepithelioma-like carcinoma (LEC) of the mandible with a view to discuss probable histogenesis from salivary gland inclusions in the mandible, effective therapy, the unusual pattern of nodal metastases, and association with the Epstein-Barr virus. An 11-year-old boy presented with a lytic lesion in the left mandible and bilateral neck node enlargement. Histologically, the biopsied metastatic neck nodes showed sinusoids distended with histiocytes and single large atypical cells that mimicked Hodgkin lymphoma. The mandibular tumor on biopsy showed morphology similar to an undifferentiated carcinoma or LEC of nasopharynx with nuclear Epstein-Barr virus-associated in situ hybridization signals. The patient received ifosfamide, cisplatin, and etoposide chemotherapy followed by a hemimandibulectomy, which did not reveal any residual tumor. Postoperative radiotherapy was completed, and 3 years later the patient is alive and free of disease.
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Affiliation(s)
- Tanuja Shet
- Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, India.
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38
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Jung H, Park SK, Heo KW, Kang MS. Lymphoepithelial carcinoma of the maxillary sinus with orbital invasion. Auris Nasus Larynx 2009; 36:487-90. [PMID: 19135324 DOI: 10.1016/j.anl.2008.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Revised: 10/17/2008] [Accepted: 10/28/2008] [Indexed: 11/25/2022]
Abstract
Lymphoepithelial carcinoma (LEC) of the maxillary sinus is a very rare neoplasm that shares some characteristics with nasopharyngeal carcinoma. Epstein-Barr virus (EBV) has been reported to be associated with LEC located outside of the nasopharynx in Asian populations. A case report of a 64-year-old Asian female with right-sided cheek mass which was diagnosed preoperatively as a maxillary mass by paranasal sinus computed tomography scan is presented. Because maxillary sinus cancer with orbital invasion was considered, she underwent surgical removal of a mass. Final pathology revealed LEC, which is presented in our report. However, in situ hybridization assays returned negative results for Epstein-Barr virus. The patient underwent postoperative chemoradiotherapy, and has remained disease-free during 3-year follow-up. Although a few cases in the maxillary LEC have been reported, this is the first report describing the diagnosis and treatment of LEC occurred in the maxillary sinus. Surgical removal and adjuvant chemoradiotherapy may be useful in the treatment of more advanced maxillary LEC.
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Affiliation(s)
- Hyun Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Inje University, College of Medicine, Pusan Paik Hospital, Busan, Republic of Korea
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39
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Mahomed F, Grayson W. A rare case of lymphoepithelial carcinoma of the lip. ACTA ACUST UNITED AC 2008; 105:e49-52. [PMID: 18442735 DOI: 10.1016/j.tripleo.2008.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Revised: 01/04/2008] [Accepted: 01/14/2008] [Indexed: 10/22/2022]
Abstract
Lymphoepithelial carcinoma (LEC) is a rare category of malignant neoplasms that share morphologic features with undifferentiated nasopharyngeal carcinoma, which can be regarded as the prototype Epstein-Barr virus (EBV)-positive epithelial neoplasm. A similar association with EBV is emerging for LEC of the oral cavity, which appears to be strongly influenced by the ethnic origin of the patient. A rare case of primary LEC of the lower lip in a 73-year-old Caucasian man is described. The tumor showed a striking microscopic resemblance to undifferentiated nasopharyngeal carcinoma (lymphoepithelioma) with features of a syncytial growth pattern, large undifferentiated tumor cells with vesicular nuclei, prominent eosinophilic nucleoli, and a dense intratumoral lymphocytic infiltrate. There was, however, no evidence of EBV infection of the tumor cells by immunohistochemistry and polymerase chain reaction, suggesting that EBV probably does not play a role in the pathogenesis of LEC of the lip in Caucasian patients.
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Affiliation(s)
- Farzana Mahomed
- Division of Oral Pathology, School of Oral Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Lee SL, Lee CY, Batniji RK, Silver S. Unilateral Tonsillar Lymphoepithelioma with Ipsilateral Parapharyngeal Space Involvement: A Case Report. EAR, NOSE & THROAT JOURNAL 2007. [DOI: 10.1177/014556130708601214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report a case of unilateral tonsillar lymphoepithelioma with extension into the ipsilateral parapharyngeal space, and we review the clinical, histologic, and radiographic findings of the case. The patient presented with a tonsillar mass that was confirmed on biopsy to be lymphoepithelioma. Computed tomography demonstrated ipsilateral parapharyngeal space involvement. Association with Epstein-Barr virus was not assessed since it does not affect the treatment modality. We also review the literature and discuss the diagnosis and current treatment options.
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Affiliation(s)
- Scott L. Lee
- Division of Otolaryngology–Head and Neck Surgery, Albany Medical Center, Albany, N.Y
| | - Ching Y. Lee
- Division of Otolaryngology–Head and Neck Surgery, Albany Medical Center, Albany, N.Y
- Department of Pathology and Laboratory Medicine, Stratton VA Medical Center, Albany, N.Y
| | - Rami K. Batniji
- Division of Otolaryngology–Head and Neck Surgery, Albany Medical Center, Albany, N.Y
| | - Steven Silver
- Division of Otolaryngology–Head and Neck Surgery, Albany Medical Center, Albany, N.Y
- Department of Otolaryngology—Head and Neck Surgery, Stratton VA Medical Center, Albany, N.Y
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Lee J, Lee SA, Kim H, Cho EY, Kim J. Lymphoepithelioma-like carcinoma in the trachea: report of a case. Surg Today 2007; 37:584-6. [PMID: 17593478 DOI: 10.1007/s00595-006-3467-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2006] [Accepted: 12/18/2006] [Indexed: 10/23/2022]
Abstract
Lymphoepithelioma-like carcinoma (LELC) is a non-nasopharyngeal undifferentiated carcinoma with prominent lymphoid infiltration. To our knowledge, only two cases of LELC in the trachea have ever been reported. This tumor has a strong association with the Epstein-Barr virus (EBV), which is especially prevalent in Asians and absent in Caucasians. We report a case of tracheal LELC with EBV-association in a 22-year-old man. The patient was treated with tracheal resection and anastomosis, followed later by adjuvant radiotherapy.
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Affiliation(s)
- Jaejin Lee
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, South Korea
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Manganaris A, Patakiouta F, Xirou P, Manganaris T. Lymphoepithelial carcinoma of the parotid gland: is an association with Epstein-Barr virus possible in non-endemic areas? Int J Oral Maxillofac Surg 2007; 36:556-9. [PMID: 17306504 DOI: 10.1016/j.ijom.2006.12.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Revised: 11/17/2006] [Accepted: 12/14/2006] [Indexed: 11/18/2022]
Abstract
Lymphoepithelial carcinoma (LEC) is a rare histological type of cancer of the salivary glands. Here is reported a case of LEC of the parotid gland that developed in a Caucasian female, whose serology was positive for Epstein-Barr virus antibody. The patient underwent surgical treatment and postoperative radiotherapy. Because of the relatively limited clinical data concerning LEC of the salivary glands compared to other more common histological types, the clinical course, optimal treatment and prognosis have not been extensively studied. The aim of this report was to summarize all the key points, following a comprehensive literature review.
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Affiliation(s)
- A Manganaris
- E.N.T. Department, THEAGENIO Anticancer Hospital, 2 Alexandrou Simeonidi Str., Thessaloniki, Greece.
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Hsiung CY, Huang CC, Wang CJ, Huang EY, Huang HY. Lymphoepithelioma-like carcinoma of salivary glands: treatment results and failure patterns. Br J Radiol 2006; 79:52-5. [PMID: 16421405 DOI: 10.1259/bjr/17905092] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this study was to evaluate the treatment results and failure patterns of lymphoepithelioma-like carcinoma (LELC) of salivary glands. From June 1987 to May 2001, nine patients with LELC of salivary glands were treated at our hospital. One patient was excluded due to the loss of clinical follow-up after surgery. For the remaining eight patients, the primary tumour sites were parotid glands (4 patients), submandibular glands (3), and the minor salivary glands in right cheek (1), respectively. Seven patients underwent surgical treatment and post-operative radiotherapy, while the other one patient was treated with surgery only. The total radiation dose to the salivary tumour bed ranged from 39.6 Gy to 67.6 Gy (mean dose: 58.3 Gy and median dose: 59 Gy). The treatment results and failure patterns were analysed. The survival time ranged from 21.4 months to 145.2 months (mean: 69.1 months, median: 54.5 months). At the end of follow-up, six patients were still alive and two died. One patient died of distant metastases 21.5 months after the surgical treatment of LELC. The other case died of intercurrent disease (pontine haemorrhage) 53 months after surgery. No patient had local or regional failure after the treatments. Distant failure was noted in two patients. The patients with LELC of salivary glands were shown to have favourable prognoses. No local or regional failure was noted. However, distant failure developed in two patients. The risk of distant metastasis should be carefully monitored, especially for those patients with more advanced neck node involvement.
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Affiliation(s)
- C-Y Hsiung
- Department of Radiation Oncology, Chang Gung Memorial Hospital-Kaoshiung, Taiwan, R.O.C
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Coskun BU, Cinar U, Sener BM, Dadas B. Lymphoepithelial carcinoma of the larynx. Auris Nasus Larynx 2005; 32:189-93. [PMID: 15917178 DOI: 10.1016/j.anl.2004.11.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2004] [Revised: 10/25/2004] [Accepted: 11/26/2004] [Indexed: 10/25/2022]
Abstract
Lymphoepithelial carcinoma (LEC) of the larynx is a rare neoplasm; with a review of the literature having disclosed only 34 documented cases. This neoplasm seems to behave in a fashion reminiscent of nasopharyngeal carcinoma. In contrast to nasopharyngeal carcinoma, most cases have not been associated with Epstein-Barr virus (EBV). The diagnosis often requires immunohistochemistry or electron microscopy for confirmation. We describe a case of this tumor involving the supraglottis. The patient was treated with supraglottic laryngectomy and bilateral modified neck dissection. The histopathological study of the surgical specimen revealed an undifferentiated carcinoma with aspects of lymphoeptihelioma. The patient underwent radiotherapy and his 2-year follow-up showed no evidence of local or distant metastasis.
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Affiliation(s)
- Berna Uslu Coskun
- Department of Otolaryngology, Sisli Etfal Training and Research Hospital, Adnan Saygun Cad. Kelaynak Sok., Kibele Sitesi 10/1 Ulus 34340, Istanbul, Turkey.
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Wang CP, Chang YL, Ko JY, Lou PJ, Yeh CF, Sheen TS. Lymphoepithelial carcinoma versus large cell undifferentiated carcinoma of the major salivary glands. Cancer 2004; 101:2020-7. [PMID: 15389474 DOI: 10.1002/cncr.20614] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Undifferentiated carcinomas of the major salivary glands are rare malignant neoplasms of the head and neck region, and patients with these lesions have a poor prognosis. Patients with lymphoepithelial carcinoma (LEC), a specific subtype of undifferentiated carcinoma, however, have a better prognosis, and LEC seems to differ from large cell undifferentiated carcinoma (LCUC) clinically. METHODS Sixteen patients with LEC and 12 patients with LCUC were retrieved from the records of 295 patients who had malignancies of the major salivary glands. A retrospective study on clinical manifestations, treatments, long-term outcomes, and an association with Epstein-Barr virus (EBV) by EBV-encoded small RNA-1 in situ hybridization was conducted to identify their differences. RESULTS The median patient age was 44.5 years in the LEC group and 56 years in the LCUC group. At the time of presentation, patients with LCUC had a history of rapid-growing tumor and more advanced locoregional disease (Stage IV in 75% of patients with LCUC compared with 13% of patients with LEC). All 16 patients with LEC underwent curative surgery and radiotherapy, and their 5-year survival rate was 85.6%. In the LCUC group, only 7 patients were eligible to undergo radical surgery and receive radiotherapy, and their 2-year survival rate was only 36%. Age > 50 years was associated with a significantly worse prognosis for patients with LCUC. Neck metastasis and tumor size > 6 cm tended to be poor prognostic factors. Tumors were positive for harboring the EBV genome in all 16 LEC samples but in none of the LCUC samples. CONCLUSIONS The clinicopathologic features of LEC and LCUC of the major salivary glands were different. LEC was associated with EBV, and patients with LEC had a much better prognosis compared with the prognosis for patients with LCUC. Therefore, LEC should be put in an independent group and should not be included in the same category as undifferentiated carcinomas of the salivary gland.
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Affiliation(s)
- Cheng-Ping Wang
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Marioni G, Mariuzzi L, Gaio E, Portaleone S, Pertoldi B, Staffieri A. Lymphoepithelial carcinoma of the larynx. Acta Otolaryngol 2002; 122:429-34. [PMID: 12126002 DOI: 10.1080/00016480260000148] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Lymphoepithelial carcinoma is a very rare tumour of the larynx, with an exhaustive review of the literature having disclosed only 33 documented cases. The relationship between lymphoepithelial carcinoma of the larynx and Epstein-Barr virus is still controversial. We describe one new case of this tumour involving the supraglottis. The patient was treated with supraglottic laryngectomy and left modified neck dissection. Three years and 4 months later, the right side of the neck was found positive for metastatic disease and a right modified neck dissection was performed. No evidence of disease was exhibited 4 years after the diagnosis of metastatic disease. The diagnostic problems and therapy associated with this rare tumour are discussed.
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Affiliation(s)
- Gino Marioni
- Department of Otolaryngology-Head and Neck Surgery, University of Padua, Italy.
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Chow TL, Chow TK, Lui YH, Sze WM, Yuen NWF, Kwok SPY. Lymphoepithelioma-like carcinoma of oral cavity: report of three cases and literature review. Int J Oral Maxillofac Surg 2002; 31:212-8. [PMID: 12102423 DOI: 10.1054/ijom.2001.0148] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Lymphoepithelioma-like carcinoma is a rare tumour in the oral cavity and is characterized histologically by non-keratinizing, undifferentiated squamous cell carcinoma with lymphocytic infiltration. Three consecutive cases of intraoral lymphoepithelioma-like carcinoma are reported. A review of the literature reveals a similar biological behaviour to that of nasopharyngeal lymphoepithelioma: a high incidence of cervical nodal spread and remarkable radiosensitivity. Chemotherapy should be considered when nodal or distant metastases are present. The association of the Epstein-Barr virus with this tumour remains unclear but our experience suggests a positive correlation in Chinese individuals.
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Affiliation(s)
- T L Chow
- Department of Surgery, United Christian Hospital, Kowloon, Hong Kong
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Jeng YM, Sung MT, Fang CL, Huang HY, Mao TL, Cheng W, Hsiao CH. Sinonasal undifferentiated carcinoma and nasopharyngeal-type undifferentiated carcinoma: two clinically, biologically, and histopathologically distinct entities. Am J Surg Pathol 2002; 26:371-6. [PMID: 11859210 DOI: 10.1097/00000478-200203000-00012] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sinonasal undifferentiated carcinoma (SNUC) is a rare aggressive neoplasm arising in the nasal cavity and paranasal sinuses. Primary sinonasal nasopharyngeal-type undifferentiated carcinoma (PSNPC) is an even rarer tumor that has not been adequately reported. Both tumors have been reported to be associated with Epstein-Barr virus (EBV). We studied the clinicopathologic features and EBV status of 36 SNUC and 13 PSNPC patients from Taiwan, an EBV endemic area. The median age of SNUC patients was 53 years (range 20-76 years), with a male/female ratio of approximately 2:1. Five patients had histories of previous nasopharyngeal carcinoma treated with irradiation 6-26 years earlier. The most common locations were nasal cavity and ethmoid sinus. Orbital and intracranial invasion and distant metastasis were frequent findings. The median survival was 10 months. All 36 tumors were negative for EBER-1 by in situ hybridization. The median age of PSNPC patients was 58 years (range 36-75 years), with a male/female ratio of approximately 2:1. The most common location is nasal cavity. Eight patients achieved disease-free survival. Eight tumors had the morphology of lymphoepithelioma, whereas significant inflammatory infiltrate was not detected in the other five tumors. All 13 tumors were positive for EBER-1 by in situ hybridization. Because of the difference in the relation with EBV, prognosis, and response to radiotherapy, SNUC and PSNPC should be considered as two entirely different entities. The most important criteria for PSNPC are vesicular nuclei, syncytial pattern, spindle cells, and absence of necrosis.
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Affiliation(s)
- Yung-Ming Jeng
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
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Reino AJ. Factors in the pathogenesis of tumors of the sphenoid and maxillary sinuses: a comparative study. Laryngoscope 2000; 110:1-38. [PMID: 11037807 DOI: 10.1097/00005537-200010001-00001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS To explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses. STUDY DESIGN A 32-year review of the world's literature on neoplasms of these two sinuses and a randomized case-controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus. METHODS Analysis of a 32-year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid-Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color-chilled 3 charge coupled device digital camera. The images were captured on a 17-inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications x 100 and x 400. RESULTS The literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands. CONCLUSIONS Factors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.
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Affiliation(s)
- A J Reino
- Manhattan Ear, Nose and Throat Associates, New York, New York 10128, USA
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