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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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Suparmaniam S, Ngoo QZ, Wan Hitam WH, Moknasing @ John PA. Sinonasal Lymphoepithelial Carcinoma With Aggressive Orbital Invasion. Cureus 2022; 14:e31103. [DOI: 10.7759/cureus.31103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/06/2022] Open
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3
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Chen M, Chen Y, Fang X, Wang Z, Pu X, Liang C, Guo H, Li Q, Pan F, Hong H, Huang H, Li J, Lin T. Clinical features and treatment outcome of lymphoepithelioma-like carcinoma from multiple primary sites: a population-based, multicentre, real-world study. BMC Pulm Med 2022; 22:360. [PMID: 36138362 PMCID: PMC9494884 DOI: 10.1186/s12890-022-02097-6] [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] [Received: 04/17/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lymphoepithelioma-like carcinoma (LELC) is a rare and unique subtype of cancer that histologically resembles undifferentiated nasopharyngeal carcinoma (NPC). The population-based analysis of LELC and the optimal treatment remains unclear. MATERIALS AND METHODS This real-world, retrospective study investigated 770 patients with LELC for primary site, treatment, and survival outcomes from 2005 to 2019 from five cancer centres in China. The overall survival (OS) of different subgroups was appraised by log-rank tests and Kaplan-Meier analysis. RESULTS Primary sites LELC included the lung (597 cases, 77.5%), salivary gland (115 cases, 14.9%), and others. The median progression-free survival (PFS) of LELC patients was 47.4 months. The median overall survival (OS) was not reached. The 5-year survival rate for LELC patients was 77.8%. Most patients in stages I and II received surgery. The majority of patients in stage III received surgery and radiotherapy. More than half of the patients in stage IV received chemotherapy. Among relapsed or metastatic cases receiving chemotherapy, patients who received immunotherapy at any time presented with a superior OS than those without immunotherapy (P < 0.0001, HR = 0.39, 95% CI 0.25-0.63). Compared with the SEER database, patients with LELC had a better prognosis than NPC, with a 5-year overall survival of 77.3% vs. 56.8% (P < 0.001). CONCLUSION Our data provide treatment patterns and outcomes for LELC from various primary sites. Randomized controlled studies are necessary to further define the standard of care for patients with LELC. Trial registration This clinical trial was registered at ClinicalTrials.gov (No. NCT04614818).
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Affiliation(s)
- Meiting Chen
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Yungchang Chen
- Senior Ward/ Phase I Clinical Trial Ward, Sichuan Cancer Hospital & Institue, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - Xiaojie Fang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Zhao Wang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Xingxiang Pu
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Yuelu District, 283 Tongzipo Road, Changsha, 410013, Hunan, China
| | - Chaoyong Liang
- Department of Medical Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | - Hongqiang Guo
- The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Qian Li
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Fei Pan
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China
| | - Huangming Hong
- Senior Ward/ Phase I Clinical Trial Ward, Sichuan Cancer Hospital & Institue, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China
| | - He Huang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China.
| | - Jiman Li
- Department of Pathology, Sichuan Cancer Hospital & Institue, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China.
| | - Tongyu Lin
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651, Dongfeng East Road, Yuexiu District, Guangzhou, 510060, China. .,Senior Ward/ Phase I Clinical Trial Ward, Sichuan Cancer Hospital & Institue, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, China.
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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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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: 1] [Impact Index Per Article: 0.3] [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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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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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: 6] [Impact Index Per Article: 1.5] [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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