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Arora M, Balasubramanian B, Mohammad Kamel Aljasem N, Arora S, Arora R. Lymphoepithelial Carcinoma of the Breast. Cureus 2023; 15:e42597. [PMID: 37521589 PMCID: PMC10375514 DOI: 10.7759/cureus.42597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 08/01/2023] Open
Abstract
Lymphoepithelial malignancy is an extremely rare carcinoma of the breast characterized by a confusing histopathological picture resembling medullary carcinomas, lymphoma, etc. It has also been reported in other regions of the body like salivary glands, nasopharyngeal area and sometimes the lung. Due to its rare presence and difficult diagnosis, the treatment is often prolonged and delayed. Here we present a case report of a 56-year-old lady who was eventually diagnosed as lymphoepithelial carcinoma of the breast. Her journey of evaluation and treatment was fraught with pathological nuances and an elimination drill of multiple differentials before concluding this rare diagnosis. Although lymphoepithelial-like carcinoma is a rare entity, multiple cases have been reported in the literature and their review is mandated to further our clinical knowledge about the oncological treatment and expected prognosis of such cases in the future. Our patient underwent a simple mastectomy, followed by chemotherapy, radiotherapy, and is completely asymptomatic now. She has been cancer-free for the last seven years so far.
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Affiliation(s)
- Mamta Arora
- Department of Surgery, NMC Specialty Hospital, Abu Dhabi, Abu Dhabi, ARE
| | | | | | - Simran Arora
- Department of Surgery, University of Debrecen, Debrecen, HUN
| | - Ravi Arora
- Department of Internal Medicine and Endocrinology, NMC Specialty Hospital, Abu Dhabi, Abu Dhabi, ARE
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2
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Salehiazar S, Huang H, Aghighi M, Venegas R. Lymphoepithelioma-Like Carcinoma of the Breast: A Case Report of a Rare Type of Invasive Carcinoma. Cureus 2022; 14:e29231. [PMID: 36258934 PMCID: PMC9573688 DOI: 10.7759/cureus.29231] [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] [Accepted: 09/16/2022] [Indexed: 12/03/2022] Open
Abstract
Lymphoepithelioma carcinoma (LELC) is an extremely rare type of mammary cancer. Based on the histology, it can be misdiagnosed with inflammatory lesions like mastitis and medullary carcinoma or other hematopoietic neoplasms like lymphoma in the breast. Since LELC has a good response to chemotherapy with a good prognosis, t is prognostically important to recognize LELC. We report a rare case of LELC in a 51-year-old pre-menopausal female with a left breast mass, diagnosed with invasive ductal carcinoma (IDC), LELC type, treated with mastectomy, followed by adjuvant chemotherapy and radiotherapy, with a disease-free interval of 10 months. Herein, we present the case with its clinical presentation, radiologic imaging, histopathological features, and immunohistochemistry (IHC) findings. The rarity of this type of breast tumor warrants studying the behavior of these uncommon tumors to avoid misdiagnosis and establish well-defined criteria for diagnosis.
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Nanev V, Naneva S, Yordanov A, Strashilov S, Konsoulova A, Vasileva-Slaveva M, Betova T, Ivanov I. Lymphoepithelioma-like Carcinoma of the Breast Synchronous with a High-Grade Invasive Ductal Carcinoma and Ductal Carcinoma in Situ in a Different Quadrant of the Same Breast: A Case Report. Medicina (B Aires) 2022; 58:medicina58091146. [PMID: 36143823 PMCID: PMC9505786 DOI: 10.3390/medicina58091146] [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: 06/26/2022] [Revised: 08/19/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Lymphoepithelioma-like breast carcinoma (LELC) is a rare type of malignant breast tumor that is not included in the current edition of the World Health Organization (WHO) classification of breast tumors. Currently, there are no clearly defined therapeutic strategies, and the general information on breast LELC is based on sporadic clinical cases described in the medical literature. We present a clinical case that describes a 49-year-old woman with a tumor formation in the right breast, histologically verified as LELC, together with a non-palpable, synchronous high-grade invasive ductal carcinoma and ductal carcinoma in situ Grade 2 (DCIS G2) in a different quadrant of the same breast. To our knowledge, this is the first case described in the literature that combines a LELC with a synchronous carcinoma in the same breast.
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Affiliation(s)
- Vasil Nanev
- Department of Surgical Oncology, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Silvia Naneva
- Hematology Clinic, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Angel Yordanov
- Department of Gynaecologic Oncology, Medical University—Pleven, 5800 Pleven, Bulgaria
- Correspondence:
| | - Strahil Strashilov
- Department of Plastic, Reconstructive and Aesthetic Surgery, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Assia Konsoulova
- USHATO—Sofia National University Cancer Hospital, 1000 Sofia, Bulgaria
- Women for Oncology, 1000 Sofia, Bulgaria
- Department of Preclinical and Clinical Disciplines, Faculty of Social Health and Healthcare, University Prof. A. Zlatarov, 8000 Burgas, Bulgaria
| | - Mariela Vasileva-Slaveva
- Department of Breast surgery, Shterev Hospital, 1000 Sofia, Bulgaria
- Research Institute, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Tatyana Betova
- Department of Clinical Pathology, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
| | - Ivan Ivanov
- Department of Clinical Pathology, Dr. Georgi Stranski University Hospital, Medical University—Pleven, 5800 Pleven, Bulgaria
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4
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Fadila K, Faycal A, Lamiaa J, Mohammed B, Nabil I. Lymphoepithelioma-like carcinoma of the breast: a case report and review of the literature. Pan Afr Med J 2019; 32:18. [PMID: 31143323 PMCID: PMC6522178 DOI: 10.11604/pamj.2019.32.18.15978] [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: 05/07/2018] [Accepted: 12/06/2018] [Indexed: 12/28/2022] Open
Abstract
Lymphoepithelioma-like carcinoma of the breast is uncommon with only 21 patients documented in the literature. It can wrongly be diagnosed as medullary carcinoma and certain types of lymphoma due to undifferentiated proliferation of malignant epithelial cells with prominent lymphoid infiltration. In this paper, we present a case of LELC of the breast in a 64-year-old female with breast LELC and a discussion based on a review of the literature.
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Affiliation(s)
- Kouhen Fadila
- Department of Radiotherapy, International University Hospital Sheikh Khalifa, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Abbad Faycal
- Department of Pathology, International University Hospital Sheikh Khalifa, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Jabri Lamiaa
- Department of Pathology, International University Hospital Sheikh Khalifa, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | | | - Ismaili Nabil
- Department of Medical Oncology, International University Hospital Sheikh Khalifa, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
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5
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Lymphoepithelioma-Like Carcinoma of the Breast: A Case Report Unveiling Several Clinical and Histopathological Challenges. Case Rep Surg 2018; 2018:8240534. [PMID: 30123609 PMCID: PMC6079566 DOI: 10.1155/2018/8240534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/07/2018] [Indexed: 12/28/2022] Open
Abstract
Lymphoepithelioma-like carcinoma (LELC) of the breast is an extremely rare tumor type. Histologically, it mimics undifferentiated nasopharyngeal carcinoma by demonstrating nests of neoplastic epithelial cells in a background of lymphoplasmacytic infiltrates. This paper reports a 62-year-old female patient with a 3 × 1.5 cm BI-RADS type IV breast mass diagnosed on excisional biopsy as LELC. The tumor is negative for estrogen and progesterone receptors and did not overexpress HER2/neu. Routine tests for clearance before surgery were performed, and patient was managed by a modified radical mastectomy with axillary lymph node dissection showing no residual tumor. Surgical CAse REports (SCARE) guidelines were followed for reporting our case. The rarity of LELC of the breast warrants the establishment and implementation of well-defined guidelines and criteria for diagnosis and management.
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Abouelfad DM, Yassen NN, Amin HAA, Shabana ME. Lymphoepithelioma-Like Carcinoma of the Breast Mimicking Granulomatous Mastitis- Case Report and Review of the Literature. Asian Pac J Cancer Prev 2017; 18:1737-1741. [PMID: 28749097 PMCID: PMC5648373 DOI: 10.22034/apjcp.2017.18.7.1737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Lymphoepithelioma-like carcinoma (LELC) of the breast is an exceedingly rare variant of mammary cancer. To our knowledge, only twenty - one cases have been reported in the literature. Diagnosis of this type of mammary carcinoma may be challenging, owing to its rarity and the histopathological similarity to common inflammatory and malignant lesions of the breast mainly granulomatous mastitis, medullary carcinoma, pleomorphic lobular carcinoma, lymphoma and other hematological malignancies. Our case is the 22nd case of lymphoepithelioma-like carcinoma reported in the breast, presenting with a palpable tender mass in a post-menopausal female. Her clinical picture had been mistaken for inflammatory disease. We present our case, with its detailed clinical history, radiological findings, histopathological and immune-histochemical findings along with a review of the literature. Highlighting this type of tumors may help in appropriate diagnosis. Moreover, studying the behavior of these rare neoplasms is essential to expedite treatment for this tumor type.
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Affiliation(s)
- Dalia M Abouelfad
- Pathology Department, Medical Division, National Research Centre, Cairo, Egypt.
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Shet T, Pai T, Shetty O, Desai S. Lymphoepithelioma-like carcinoma of breast-evaluation for Epstein-Barr virus-encoded RNA, human papillomavirus, and markers of basal cell differentiation. Ann Diagn Pathol 2016; 25:42-47. [PMID: 27806845 DOI: 10.1016/j.anndiagpath.2016.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/05/2016] [Accepted: 05/26/2016] [Indexed: 12/26/2022]
Abstract
This is a largest series of 5 cases of lymphoepithelioma-like carcinoma (LEC) of the breast attempting to look at the expression of basal cytokeratins (CKs), human papillomavirus, and Epstein-Barr virus-encoded RNAs in these tumors. Five cases were selected after stringent evaluation of all breast carcinomas showing dense lymphoid infiltration. Histologically, all these tumors showed the typical histology except 1 tumor that showed an unusual granulomatous response. All tumors were negative for estrogen and progesterone receptors and HER2 (triple negative). Three tumors expressed CK5/6 and high-molecular-weight CK, whereas only the case with nodal metastasis expressed CK14. Analysis for in situ hybridization for Epstein-Barr virus-encoded RNAs and human papillomavirus DNA on paraffin-processed tissues was negative in all tumors. All of these patients received adjuvant therapy. One patient with tumor expressing basal marker, CK5/6, had contralateral breast malignancy after a duration of 53 months of treatment completion. The rest were disease free with the follow-up period in the range of 6 to 105 months. The lymphoepithelioma-like carcinoma of breast expressed basal CK profile that is more CK5/6 positive than CK14. Analysis of basal markers within these tumors may help in refining the definition of these tumors and in classifying them into prognostically relevant groups.
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Affiliation(s)
- Tanuja Shet
- Divisions of Surgical and Molecular Pathology, Department of Pathology, Tata Memorial Hospital (TMH) & Advanced Centre for Training, Research & Education in Cancer (ACTREC), Mumbai, India.
| | - Trupti Pai
- Divisions of Surgical and Molecular Pathology, Department of Pathology, Tata Memorial Hospital (TMH) & Advanced Centre for Training, Research & Education in Cancer (ACTREC), Mumbai, India
| | - Omshree Shetty
- Divisions of Surgical and Molecular Pathology, Department of Pathology, Tata Memorial Hospital (TMH) & Advanced Centre for Training, Research & Education in Cancer (ACTREC), Mumbai, India
| | - Sangeeta Desai
- Divisions of Surgical and Molecular Pathology, Department of Pathology, Tata Memorial Hospital (TMH) & Advanced Centre for Training, Research & Education in Cancer (ACTREC), Mumbai, India
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8
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Abstract
Lymphoepithelioma-like carcinoma of the breast is a rare malignancy, with fewer than 20 cases documented in the literature. Given the paucity of reported cases, there is limited information available to guide the diagnosis and management of patients with this tumor. We present a case of a 39-year-old woman with a palpable right breast mass that was initially diagnosed by core needle biopsy as infiltrating carcinoma with prominent lymphoplasmacytic stroma. Subsequent neoadjuvant chemotherapy with docetaxel, doxorubicin, and cyclophosphamide resulted in a marked decrease in the size of the mass. After wide local surgical excision, pathology revealed a lymphoepithelioma-like carcinoma of the breast. Given the excellent treatment response, our experience may help clinicians determine future therapeutic strategies for this rare breast tumor.
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9
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Abdou AG, Asaad NY. Lymphoepithelioma-like carcinoma of the breast: cytological, histological, and immunohistochemical characteristics. Diagn Cytopathol 2014; 43:210-3. [PMID: 24610805 DOI: 10.1002/dc.23141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 01/14/2014] [Accepted: 02/24/2014] [Indexed: 12/14/2022]
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10
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Dinniwell R, Hanna WM, Mashhour M, Saad RS, Czarnota GJ. Lymphoepithelioma-like carcinoma of the breast: a diagnostic and therapeutic challenge. ACTA ACUST UNITED AC 2012; 19:e177-83. [PMID: 22670107 DOI: 10.3747/co.19.926] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We present a patient with lymphoepithelioma-like carcinoma (LELC) of the breast whose diagnosis is illustrative of the pathology nuances that must be taken into account to successfully reach correct identification of the disease. We also present an overview of our patient's proposed treatment in the context of 16 other reported LELC cases. Although LELC cases are rare, a sufficient number have been reported to discern the natural history of this pathologic entity and to undertake a review of those cases and of the application of oncologic first principles in their management. Given the potential for locoregional spread and distant metastases in LELC, adjuvant therapy has a role in the treatment of this entity.
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Affiliation(s)
- R Dinniwell
- Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON.
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Jeong AK, Park SB, Kim YM, Ko BK, Yang MJ, Kwon WJ, Lee JH, Weon YC. Lymphoepithelioma-like carcinoma of the breast. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:485-488. [PMID: 20194945 DOI: 10.7863/jum.2010.29.3.485] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Ae Kyung Jeong
- Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
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12
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Amarante MK, Watanabe MAE. The possible involvement of virus in breast cancer. J Cancer Res Clin Oncol 2008; 135:329-37. [PMID: 19009309 DOI: 10.1007/s00432-008-0511-2] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Accepted: 10/28/2008] [Indexed: 12/25/2022]
Abstract
It is well known that the etiology of human breast cancer is significantly affected by environmental factors. Virus-associated cancer refers to a cancer where viral infection results in the malignant transformation of the host's infected cells. Human papillomaviruses (HPV), mouse mammary tumor virus (MMTV) and Epstein-Barr (EBV) virus are prime candidate viruses as agents of human breast cancer. The precise role that viruses play in tumorigenesis is not clear, but it seems that they are responsible for causing only one in a series of steps required for cancer development. The idea that a virus could cause breast cancer has been investigated for quite some time, even though breast cancer could be a hereditary disease; however, hereditary breast cancer is estimated to account for a small percentage of all breast cancer cases. Based on current research, this review present at moment, substantial, but not conclusive, evidence that HPV, EBV and MMTV may be involved in breast cancer.
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Affiliation(s)
- Marla Karine Amarante
- Department of Pathological Sciences, Biological Sciences Center, State University of Londrina, Londrina, PR, Brazil
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Kulka J, Kovalszky I, Svastics E, Berta M, Füle T. Lymphoepithelioma-like carcinoma of the breast: not Epstein-Barr virus-, but human papilloma virus-positive. Hum Pathol 2008; 39:298-301. [PMID: 18206498 DOI: 10.1016/j.humpath.2007.08.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 08/07/2007] [Accepted: 08/10/2007] [Indexed: 12/17/2022]
Abstract
Lymphoepithelioma-like carcinoma of the breast is a rare tumor, with fewer than 20 cases documented in the literature. None of the published cases was Epstein-Barr virus positive, and our case was also Epstein-Barr virus negative. However, in our case, human papilloma virus (HPV) types 18 and 33 DNA could be demonstrated within the tumor tissue. Many years previously, the patient underwent hysterectomy for cervical carcinoma in situ which showed the presence of HPV-33. To the best of our knowledge, this is the first report on lymphoepithelioma-like carcinoma of the breast where high-risk HPV infection may be suggested as an etiological factor in a patient with a previous history of cervical carcinoma in situ.
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Affiliation(s)
- Janina Kulka
- 2nd Department of Pathology, Semmelweis University, Budapest 1091, Hungary.
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