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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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2
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Wei J, Deng H, Wu L, Song J, Zhang J, Yang W, Zhang M, Zhen H. Lymphoepithelial carcinoma of the head and neck: a SEER analysis of prognostic factors for survival. J Int Med Res 2023; 51:3000605221148895. [PMID: 36650910 PMCID: PMC9869209 DOI: 10.1177/03000605221148895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To explore the epidemiological characteristics of patients with lymphoepithelial carcinoma (LEC) of the head and neck and the prognostic factors. METHODS We conducted a retrospective cohort study of cases of head and neck LEC retrieved from the Surveillance, Epidemiology and End Results database. Kaplan-Meier survival analysis and the log-rank test were employed to assess overall survival (OS) and cancer-specific survival (CSS). Univariate and multivariate analyses were used to construct Cox regression models. We established nomograms to predict OS and CSS among patients with nasopharyngeal LEC, who were divided into high- and low-risk groups based on the OS nomograms to compare the effects of treatment using the restricted mean survival time (RMST). RESULTS The 5-year OS and CSS rates of the cohort were 70.8% and 74.8%, respectively. Advanced age, unmarried status, black race, distant metastasis, and the absence of surgical treatment were significantly associated with decreased survival rates. RMST did not differ between the combined treatment (radiotherapy and chemotherapy) and radiotherapy monotherapy groups, but chemotherapy alone displayed poor efficacy. CONCLUSIONS Head and neck LEC is associated with a favorable prognosis. Radiotherapy plays a significant role in managing patients with nasopharyngeal LEC, which is influenced by multiple prognostic factors.
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Affiliation(s)
- Jing Wei
- Cancer Center of Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Taiyuan, China
| | - Hui Deng
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lihua Wu
- Cancer Center of Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Taiyuan, China
| | - Jianbo Song
- Cancer Center of Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Taiyuan, China
| | - Junping Zhang
- Cancer Center of Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Taiyuan, China
| | - Wenhui Yang
- Cancer Center of Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Taiyuan, China
| | - Mengxian Zhang
- Cancer Center of Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Taiyuan, China,Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Hongtao Zhen
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China,Hongtao Zhen, Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei, China.
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3
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Nath J, Sarma G, Das A, Das K, Kakati L. Lymphoepithelial carcinoma of the larynx: A clinical report with pooled analysis and review of published cases. J Cancer Res Ther 2023; 19:S466-S471. [PMID: 38384006 DOI: 10.4103/jcrt.jcrt_1390_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/16/2022] [Indexed: 02/23/2024]
Abstract
ABSTRACTS Lymphoepithelial carcinoma (LEC) of the larynx is a rare tumor comprising 0.2% of all laryngeal neoplasms. To our knowledge, less than 50 cases of LEC of the larynx are reported in the literature. The lack of specific guidelines leads to uncertainty on this rare entity's diagnosis, treatment, and follow-up. The association of Epstein-Barr virus as a predisposing factor of LEC has been proposed in a few reports. Although the occurrence of LEC in the larynx is infrequent, it is essential to differentiate it from squamous cell carcinoma. Immunohistochemistry should be performed to demonstrate cytokeratin expression. It is a very aggressive tumor with high metastatic potential; however, it is hard to comment on the disease outcome of LEC of the larynx because only case reports are available in the literature. Here, we report a case of LEC of the larynx (CK +ve, CD 45 -ve, and EBER-ISH -ve) in a 49-year-old male. Initially, the patient was planned for surgery but defaulted. He reported back after 4 months, and there was clinicoradiological disease progression. Because of the unresectable status and poor general condition, he received palliative radiotherapy only. Additionally, we have conducted a pooled analysis of the individual cases of LEC of larynx available in the literature to understand the clinical behavior to optimize the treatment of these patients.
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Affiliation(s)
- Jyotiman Nath
- Department of Radiation Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
| | - Gautam Sarma
- Department of Radiation Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
| | - Ankita Das
- Department of Radiation Oncology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
| | - Kishore Das
- Department of Head and Neck Surgery, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
| | - Lopamudra Kakati
- Department of Oncopathology, Dr. B Borooah Cancer Institute, Guwahati, Assam, India
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4
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Nogal P, Staśkiewicz M, Jackowska J, Wierzbicka M. Lymphepithelial carcinoma - a rare tumor of the larynx. Case Report. Front Surg 2022; 9:851481. [PMID: 36386509 PMCID: PMC9650521 DOI: 10.3389/fsurg.2022.851481] [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: 01/09/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022] Open
Abstract
Lymphoepithelioma was described in 1921 separately by Regaud and Schmincke as nests of non-keratinizing squamous cells embedded in a lymphoid stroma (Regaud) and isolated transitional cells scattered in lymphoid tissue resembling sarcoma (Schmincke). Lymphoepithelial tumors are the most common lesions of the nasopharynx, although they have also been reported in other localizations, such as the nasal cavity, maxillary sinus, the base of the tongue, parapharyngeal area, tonsils and thymus. Lymphoepithelioma of the larynx is extremely rare. We present a case of a 55-year-old patient treated due to this type of lesion to share our experience in the management of this type of malignancy and contribute to the field of rare laryngeal tumors diagnosis and treatment.
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5
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Petruzzi G, Costantino A, De Virgilio A, Zocchi J, Campo F, Mercante G, Spriano G, Pellini R. Lymphoepithelial carcinoma of larynx and hypopharynx: a systematic review and pooled analysis. Eur Arch Otorhinolaryngol 2021; 279:1157-1166. [PMID: 34338877 DOI: 10.1007/s00405-021-07011-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/20/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To define the oncologic outcomes and the prognostic factors of laryngeal and hypopharyngeal lymphoepithelial carcinoma (LEC). METHODS A systematic review and individual patient data analysis were performed according to the PRISMA guidelines. A total of 41 patients (males: 37; mean age: 63.1, standard deviation: 10.0) were included. RESULTS The median follow-up time was 36.0 months (interquartile range, IQR: 11.5-73.5), while the median overall survival (OS) time was 96 months (IQR: 39.0-120.0). Estimated disease-specific survival (DSS) rates (95% Confidence Interval, CI; number still at risk) at 1, 3, and 5 years were 94.4% (79.5-98.6; 31), 82.7% (62.7-92.5; 21), and 78.1% (56.8-89.7; 13), respectively. Estimated disease-free survival (DFS) rates (95% CI; number still at risk) at 1, 3, and 5 years were 92.1% (77.4-97.4; 31), 74.9% (55.6-86.8; 21), and 66.6% (46.1-80.8; 13), respectively. Patients undergoing primary surgery had a reduced chance of death from cancer than patients receiving primary radiotherapy (5-year DSS 85.6 vs. 56.2%; p = 0.04), while EBV positivity tend to be a negative prognostic factor (5-year DSS 100 vs. 66.7%; p = 0.05). CONCLUSIONS Laryngeal and hypopharyngeal LEC is a rare disease with favorable survival. Further prospective multicenter studies are needed to make a reliable statement on prognosis and outcome, stratifying patients for different therapy regimens and tumor stages.
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Affiliation(s)
- Gerardo Petruzzi
- Department of Otolaryngology and Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy. .,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy.
| | - Jacopo Zocchi
- Department of Otolaryngology and Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Flaminia Campo
- Department of Otolaryngology and Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy.,Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Raul Pellini
- Department of Otolaryngology and Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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6
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da Costa REAR, da Silva Júnior RG, Magalhães LAN, Mendes JR, Dos Reis CA. Locally advanced lymphoepithelial carcinoma of the larynx/hypopharynx: A case report. Oral Oncol 2021; 118:105373. [PMID: 34092507 DOI: 10.1016/j.oraloncology.2021.105373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 05/22/2021] [Accepted: 05/27/2021] [Indexed: 11/19/2022]
Abstract
Lymphoepithelial carcinoma (LEC) is an uncommon, aggressive cancer that affects mainly the nasopharynx (a form that is closely related to the Epstein-Barr virus). LEC of the larynx/hypopharynx is extremely rare, accounting for only 0.2% of malignant tumors of the larynx. This study describes a case of locally advanced LEC of the larynx/hypopharynx with effective response to chemoradiation (an option that spares the patient from the risks of surgical resection). A 60-year-old sedentary, hypertensive male patient with a previous history of smoking and alcohol abuse received a histopathological diagnosis of locally advanced LEC of the larynx/hypopharynx in May 2018. He underwent treatment with chemoradiation and exhibited a complete clinical response. At about 3 years of follow-up, the patient is currently alive, free from disease and has not presented any tumor recurrences.
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7
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Hackenberg S, Kraus F, Scherzad A. Rare Diseases of Larynx, Trachea and Thyroid. Laryngorhinootologie 2021; 100:S1-S36. [PMID: 34352904 PMCID: PMC8363221 DOI: 10.1055/a-1337-5703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This review article covers data on rare diseases of the larynx, the trachea and the thyroid. In particular, congenital malformations, rare manifestations of inflammatory laryngeal disorders, benign and malignant epithelial as well as non-epithelial tumors, laryngeal and tracheal manifestations of general diseases and, finally, thyroid disorders are discussed. The individual chapters contain an overview of the data situation in the literature, the clinical appearance of each disorder, important key points for diagnosis and therapy and a statement on the prognosis of the disease. Finally, the authors indicate on study registers and self-help groups.
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Affiliation(s)
- Stephan Hackenberg
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
| | - Fabian Kraus
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
| | - Agmal Scherzad
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten,
plastische und ästhetische Operationen, Universitätsklinikum
Würzburg
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8
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Faisal M, Hartenbach S, Schratter A, Köstler WJ, Kaufmann H, Seemann R, Lill C, Hamzavi S, Wutzl A, Erovic BM. Lymphoepithelial Carcinoma of Larynx and Hypopharynx: A Rare Clinicopathological Entity. Cancers (Basel) 2020; 12:cancers12092431. [PMID: 32867094 PMCID: PMC7565469 DOI: 10.3390/cancers12092431] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/05/2022] Open
Abstract
(1) Background: Lymphoepithelial carcinoma of the hypopharynx and larynx is a rare tumor with fewer than 50 cases in the published literature. We present a literature review to discuss the clinical findings, viral or genetic associations, diagnostic challenges, histopathological findings and therapeutic aspects of the disease. (2) Methods: A comprehensive literature review was performed through MEDLINE/PubMed from 1968 to 2018. We identified 21 studies comprising 46 patients. Data on all the clinicopathological features, diagnostic modalities, treatment options and viral or genetic etiology were extracted and analyzed using SPSS. (3) Results: The mean age of presentation was 64 years (range 40–82 years) and mostly involved males. The supraglottis and pyriform sinus were the most commonly involved sub-sites, with surgery as the preferred treatment modality. The presence of the Epstein–Barr virus possibly directs a viral etiology. The incidence of cervical and distant metastasis was 54% and 21%, respectively. The median survival time was 30 months. (4) Conclusions: Lymphoepithelial carcinoma of the hypopharynx is an aggressive tumor with a strong predilection for regional and distant metastasis. Surgery, in combination with adjuvant therapy, provides promising results. Immunohistochemistry helps in differentiating LEC from other pathologies.
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Affiliation(s)
- Muhammad Faisal
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (M.F.); (R.S.); (C.L.); (S.H.); (A.W.)
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore 54000, Pakistan;
| | - Sabrina Hartenbach
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore 54000, Pakistan;
| | - Annemarie Schratter
- Institute of Radio-Oncology, Kaiser-Franz-Josef Hospital, 1180 Vienna, Austria;
| | - Wolfgang J. Köstler
- Clinical Division of Oncology, Department of Medicine, Comprehensive Cancer Center, Medical University of Vienna, 1180 Vienna, Austria;
| | - Hannes Kaufmann
- Clinical Oncology and Hematology, Kaiser-Franz-Josef Hospital, 1180 Vienna, Austria;
| | - Rudolf Seemann
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (M.F.); (R.S.); (C.L.); (S.H.); (A.W.)
| | - Claudia Lill
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (M.F.); (R.S.); (C.L.); (S.H.); (A.W.)
| | - Sasan Hamzavi
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (M.F.); (R.S.); (C.L.); (S.H.); (A.W.)
| | - Arno Wutzl
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (M.F.); (R.S.); (C.L.); (S.H.); (A.W.)
| | - Boban M. Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital, 1180 Vienna, Austria; (M.F.); (R.S.); (C.L.); (S.H.); (A.W.)
- Correspondence: ; Tel.: +43-1-404-224-518
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9
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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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10
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Human papillomavirus in laryngeal and hypopharyngeal lymphoepithelial carcinoma. Mod Pathol 2019; 32:621-626. [PMID: 30552415 DOI: 10.1038/s41379-018-0188-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/16/2018] [Accepted: 11/16/2018] [Indexed: 01/07/2023]
Abstract
The involvement of human papillomavirus (HPV) in laryngeal and hypopharyngeal lymphoepithelial carcinoma was investigated in a series of ten cases (seven laryngeal and three hypopharyngeal), retrieved from the files of three tertiary hospitals in the 2000-2017 period, through polymerase chain reaction with SPF10 primers and INNO-LiPA HPV Genotyping Extra II (Innogenetics). Epstein-Barr virus (EBV) was tested in all cases with in situ hybridization INFORM EBER Probe (Ventana Medical Systems). p16 and p53 expression were immunohistochemically analyzed. Calculated annual incidence was 0.013/100,000, and prevalence was 0.2% of laryngeal and hypopharyngeal carcinomas. All cases were EBV negative. HPV was detected in five cases, three of which also overexpressed p16. HPV16 was detected in four cases, and HPV58 in one case. Five cases were HPV negative, only one of these five overexpressed p16. No recurrence was observed in nine cases during follow-up. The 5-year disease-specific-survival rate was 100%. Mean overall survival was 87 months. Lymphoepithelial carcinoma of the larynx and hypopharynx are not related to EBV. Simultaneous HPV+/p16+ is consistent with HPV causation in a fraction of laryngeal and hypopharyngeal lymphoepithelial carcinomas.
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11
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Variants des carcinomes épidermoïdes dans les voies aérodigestives supérieures (VADS), implications pour le diagnostic et la prise en charge, selon les référentiels du REFCOR. Bull Cancer 2019; 106:395-403. [DOI: 10.1016/j.bulcan.2019.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 01/19/2019] [Indexed: 01/06/2023]
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12
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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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13
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Hammas N, Benmansour N, El Alami El Amine MND, Chbani L, El Fatemi H. Lymphoepithelial carcinoma: a case report of a rare tumor of the larynx. BMC Clin Pathol 2017; 17:24. [PMID: 29204101 PMCID: PMC5702189 DOI: 10.1186/s12907-017-0061-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lymphoepithelial carcinoma is a tumor mostly diagnosed in the nasopharynx, but it has also been described in a variety of nonnasopharyngeal sites. It is extremely rare in the larynx and should be distinguished from squamous cell carcinoma. Therefore, it must be known by clinicians, pathologists and oncologists. In this case report, we discuss its etiopathogeny, its epidemiological, clinical, pathological and therapeutic aspects, and its outcome. CASE PRESENTATION An 81-year-old Morrocan man, smoker for 40 years, presented with a 1 year history of dysphonia, dyspnea and dysphagia. Laryngoscopy showed a mass occupying supraglottic, glottic and subglottic levels of the larynx. Cervico-thoracic computed tomography scan showed a laryngeal wall thickening with cervical lymphadenopathy. Laryngeal biopsy was performed. Microscopic analysis and immunohistochemistry confirmed the diagnosis of laryngeal lymphoepithelial carcinoma. Immunostaining for LMP1 was negative. CONCLUSION Laryngeal lymphoepithelial carcinoma is an extremely rare and an aggressive tumor. It is rarely associated with the EBV. It must be regarded as a distinct entity. Radiotherapy is advisable as the unique therapy for local tumor. A correct diagnosis and a close collaboration between the pathologist and clinicians is mandatory for an optimal treatment strategy.
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Affiliation(s)
- Nawal Hammas
- Department of Pathology, Hassan II University Hospital, 30000 Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Najib Benmansour
- Department of otorhinolaryngology, HASSAN II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Mohamed Nour-dine El Alami El Amine
- Department of otorhinolaryngology, HASSAN II University Hospital, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Laila Chbani
- Department of Pathology, Hassan II University Hospital, 30000 Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Hind El Fatemi
- Department of Pathology, Hassan II University Hospital, 30000 Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
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14
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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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15
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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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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: 14] [Impact Index Per Article: 1.6] [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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18
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Ibrahimov M, Yilmaz M, Celal MH, Mamanov M, Yollu U, Ozek H. Lymphoepithelial Carcinoma of the Larynx. J Craniofac Surg 2013; 24:1049. [DOI: 10.1097/scs.0b013e3182700cd9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Khouchani M, Elmorabit B, Elomrani A, Tahri A, Moutaouakil A, Belabidia B. [Lymphoepithelial carcinoma of the conjunctiva: an unusual location]. Cancer Radiother 2012; 16:219-21. [PMID: 22503368 DOI: 10.1016/j.canrad.2012.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 02/19/2012] [Accepted: 02/22/2012] [Indexed: 11/16/2022]
Abstract
Lymphoepithelial carcinoma is an undifferentiated carcinoma associated with a lymphocytic infiltration and constitutes a rare category of malignant neoplasms that share morphologic features with undifferentiated nasopharyngeal carcinoma. Its pathogenic aspects remain unknown and it has been described at several sites, but it is rarely found in the conjunctiva. We report a case in a patient aged 66, revealed by a tumefaction of the internal angle of the left eye. The initial examination found a tumoral lesion in the medial canthus, extending to the medial half of the lower eyelid and a preauricular lymphadenopathy. Facial computed tomography scan showed that the lesion was responsible for an osteolysis of the medial wall of the left orbit. Histologic examination showed a proliferation of undifferentiated tumour cells with an intratumoral lymphocytic infiltrate. Immuno-histochemical evaluation led to a diagnosis of lymphoepithelial carcinoma (cytokeratin 7+, cytokeratin 20+, vimentin-). No Epstein-Barr viral genomic sequences were detected by in situ hybridization. Nasofibroscopy was normal. Treatment was a wide excision with enucleation, followed by 50 Gy external radiotherapy. After a follow-up period of 18 months, the patient was still in a situation of complete remission.
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Affiliation(s)
- M Khouchani
- Service d'oncologie-radiothérapie, centre hospitalier universitaire Mohamed-VI, Marrakech, Maroc.
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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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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: 17] [Impact Index Per Article: 0.9] [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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Christ S, Biebel UW, Hoidis S, Friedrichsen S, Bauer K, Smolders JWT. Hearing Loss in Athyroid Pax8 Knockout Mice and Effects of Thyroxine Substitution. Audiol Neurootol 2004; 9:88-106. [PMID: 14981357 DOI: 10.1159/000076000] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2003] [Accepted: 10/02/2003] [Indexed: 11/19/2022] Open
Abstract
Pax8-/- mice do not develop thyroid follicular structures and thus provide an ideal animal model to study the consequences of congenital hypothyroidism. Despite their athyroidism, Pax8-/- mice survive up to postnatal day 21 (P21). No auditory brain stem responses (ABR) to sound could be recorded in these animals at 130 dB SPL, even at P21, when hearing reaches adult sensitivity in control mice. Abnormalities in the outer and middle ear structures were found in a considerable percentage of Pax8-/- animals. Maturation of the inner ear appeared delayed by about 1 week with respect to euthyroid controls. Hearing of adult Pax8-/- mice could be nearly normalized by early postnatal substitution with thyroxine (T(4)), but structural and functional restoration of hearing was incomplete. Even when T(4) substitution was initiated at P1, ABR thresholds, measured at 6 weeks of age or more, were increased by about 20 dB, and each day of delay in the start of T(4) substitution resulted in an additional threshold loss of about 4 dB. The most prominent structural deficit in Pax8-/- animals in which T(4) substitution was started at P8 or later was an abnormally thick tectorial membrane. In these late-substituted animals, disarray of stereovilli from inner and outer hair cells was observed and also outer hair cell loss was found, predominantly in the basal part of the cochlea. The degree of structural disorder increased the later T(4) substitution was initiated. The structural and functional consequences of postnatal athyroidism observed in Pax8-/- mice are largely in agreement with and extend those data obtained from hypothyroid animal models in which hypothyroidism was induced by goitrogenic agents (methimazole, propylthiouracil) or animal models with disrupted genes for the TSH receptor or the thyroid hormone receptors. The hearing loss and also the recovery effect by T(4) substitution in Pax8-/- mice is larger than that in the other models. Although Pax8-/- mice are born by euthyroid Pax8+/- dams, the Pax8-/- phenotype could not be completely restored by immediate postnatal T(4) substitution, indicating that some deficits are the consequence of prenatal T(4) deficiency of the offspring.
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Affiliation(s)
- Stephanie Christ
- Max-Planck-Institut für experimentelle Endokrinologie, Hannover, Germany
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