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Gupta S, Singh AC, Agarwal T, Kumari N, Rajwanshi A. Cytological diagnosis of lymphoepithelial carcinoma: Simple yet confusing. Diagn Cytopathol 2024. [PMID: 38973413 DOI: 10.1002/dc.25381] [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: 06/06/2024] [Accepted: 07/01/2024] [Indexed: 07/09/2024]
Abstract
Lymphoepithelial carcinoma (LEC) of salivary glands are rare tumours and present as gradually progressing painless masses. LECs have good prognosis and accurate differentiation from secondary tumours and nasopharyngeal carcinoma is essential to dictate management. We present a case of an elderly male presenting with a parotid swelling diagnosed as LEC on fine needle aspiration cytology and confirmed on histopathology and immunohistochemistry.
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Affiliation(s)
- Shruti Gupta
- Department of Pathology, All India Institute of Medical Sciences, Raebareli, India
| | - Avinash Chandra Singh
- Department of Surgical Oncology, All India Institute of Medical Sciences, Raebareli, India
| | - Tanya Agarwal
- Department of Pathology, All India Institute of Medical Sciences, Raebareli, India
| | - Niraj Kumari
- Department of Pathology, All India Institute of Medical Sciences, Raebareli, India
| | - Arvind Rajwanshi
- Executive Director, All India Institute of Medical Sciences, Raebareli, India
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2
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Kallel S, Ayadi S, Salem N, Zghal M, Mariem BA, Ayedi L, Mnejja M, Boudawara T, Charfeddine I. Lymphoepithelial carcinoma of the parotid gland. SAGE Open Med Case Rep 2024; 12:2050313X241260210. [PMID: 38868663 PMCID: PMC11168047 DOI: 10.1177/2050313x241260210] [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: 11/27/2023] [Accepted: 05/22/2024] [Indexed: 06/14/2024] Open
Abstract
Primary lymphoepithelial carcinoma of the salivary glands is an exceptional oncological condition that predominantly emerges within the parotid gland. A significant prevalence of lymphoepithelial carcinoma has been reported in the Inuit population, along with an associated positive serology for Epstein-Barr virus in these endemic regions. In this paper, we present a case of primary lymphoepithelial carcinoma of the parotid gland in a 68-year-old female patient with a history of diabetes and hypertension residing in a non-endemic area. Histology plays a critical role in the definitive diagnosis, and confirming the primary origin of lymphoepithelial carcinoma after ruling out metastasis from undifferentiated nasopharyngeal carcinoma. The mainstay of treatment is a combination of surgical resection and adjuvant radiotherapy. Inoperable forms are typically managed with chemoradiotherapy.
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Affiliation(s)
- Souha Kallel
- ENT Department and Research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Sirine Ayadi
- ENT Department and Research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Noura Salem
- ENT Department and Research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Mouna Zghal
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Ben Ayed Mariem
- ENT Department and Research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Lobna Ayedi
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Malek Mnejja
- ENT Department and Research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Tahya Boudawara
- Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Ilhem Charfeddine
- ENT Department and Research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
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Fujii H, Fujita A, Nishino H, Matsuki M, Mori H. Magnetic Resonance Imaging Findings of Lymphoepithelial Carcinoma of the Submandibular Gland: A Case Report. Cureus 2023; 15:e49939. [PMID: 38179348 PMCID: PMC10765211 DOI: 10.7759/cureus.49939] [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: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Lymphoepithelial carcinoma (LEC) is an uncommon neoplasm strongly associated with Epstein-Barr virus (EBV). LEC of the salivary glands (LECSG) is very rare: the most commonly affected site is the parotid gland, followed by the submandibular gland. This report describes the case of a 58-year-old man who presented with a left submandibular mass that had gradually increased in size over five years. On magnetic resonance imaging (MRI), the mass showed low apparent diffusion coefficient (ADC) values, rapid initial enhancement before reaching a plateau on dynamic contrast-enhanced MRI (DCE-MRI), and internal septal-like enhancement. Histopathologically, the tumor comprised polygonal or round tumor cells with atypical or pleomorphic nuclei and numerous lymphocytes, separated by heavy fibrosis. Immunohistological findings were positive for AE/AE3, CD20, and EBV-encoded small RNA in situ hybridization (EBER-ISH), consistent with LEC. A low ADC value with rapid initial enhancement before reaching a plateau on DCE-MRI was thought to reflect abundant cellular components with tumor neoangiogenesis, whereas internal septal-like enhancement reflects separating heavy fibrosis. To the best of our knowledge, this is the first case report describing ADC value and DCE-MRI findings of LECSG, and these findings can be considered characteristic MRI findings of LECSG.
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Affiliation(s)
- Hiroyuki Fujii
- Radiology, Jichi Medical University, School of Medicine, Shimotsuke, JPN
| | | | - Hiroshi Nishino
- Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Shimotsuke, JPN
| | - Mitsuru Matsuki
- Radiology, Jichi Children's Medical Center Tochigi, Shimotsuke, JPN
| | - Harushi Mori
- Radiology, Jichi Medical University, School of Medicine, Shimotsuke, JPN
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4
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He S, He D, Li J, Yu H, Bai S, Xu C, Huang Y. The role of postoperative radiotherapy (PORT) in lymphoepithelial carcinoma of the salivary gland (LECSG) and the effect of postoperative EBV DNA on prognosis. Radiother Oncol 2023; 188:109893. [PMID: 37659661 DOI: 10.1016/j.radonc.2023.109893] [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: 06/07/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND Whether postoperative radiotherapy (PORT) could improve survival and the role of EBV DNA remains unclear for patients with lymphoepithelial carcinoma of the salivary glands (LECSG). PATIENTS AND METHODS 360 patients were included. Independent prognostic factors were selected using a Cox proportional hazards model and incorporated into risk stratification. RESULTS The number of positive lymph nodes (PLNs) ≥ 3 and tumor size ≥ 3 cm were independent factors for PFS in patients with neck dissection (ND). Patients were divided into three groups: high-risk, size ≥ 3 cm&PLNs ≥ 3; intermediate-risk, size < 3 cm&PLNs ≥ 3 or size ≥ 3 cm&PLNs < 3; low-risk, size < 3 cm&PLNs < 3. The 5-year PFS rate of the low-, intermediate- and high-risk patients receiving non-PORT and PORT was 87.9% vs 93.5% (p = 0.12), 41.2% vs 81.1% (p < 0.001), 18.0% vs 51.1% (p = 0.034). N stage was an independent factor for PFS in patients with non-neck dissection (NND) and patients were divided into two groups: low-risk, N0; and high-risk, N1/2. The 5-year PFS rate of the low-risk, and high-risk patients receiving non-PORT and PORT was 77.9% vs 94.3% (p = 0.0019), 21.4% vs 71.3% (p = 0.015). Compared with EBV DNA = 0, the 5-year PFS rate of patients with EBV DNA > 0 was 19.9% vs 91.3% (p < 0.001). In patients with EBV DNA = 0, the 5-year PFS rate of patients with or without PORT was 95.1% vs 92.3% (p = 0.082); while in patients with EBV DNA > 0, the 5-year PFS rate was 37% vs 9.2% (p = 0.0056). CONCLUSIONS In patients with ND, PLNs < 3&size < 3 cm patients did not benefit from PORT. Detectable EBV DNA after surgery was a negative prognostic factor.
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Affiliation(s)
- Shuiqing He
- 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, 510060, Guangzhou, China
| | - Danjie He
- 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, 510060, Guangzhou, China
| | - Jiaxin Li
- Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China
| | - Hongwei Yu
- Department of Radiotherapy, Cancer Hospital of Guangzhou Medical University, Guangdong, Guangzhou 510095, China
| | - Shoumin Bai
- Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Cheng Xu
- 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, 510060, Guangzhou, China.
| | - Ying Huang
- 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, 510060, Guangzhou, China.
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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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6
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Ishak AI, Kong LS, Yunus MRM, Bakar MZA. Primary Lymphoepithelial Carcinoma of the Submandibular Gland in A Young Patient: A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:2577-2580. [PMID: 37636741 PMCID: PMC10447739 DOI: 10.1007/s12070-023-03663-y] [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: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 08/29/2023] Open
Abstract
Lymphoepithelial carcinoma (LEC) is a rare entity of malignancy. It has been associated with Epstein-Barr virus (EBV), and in regions where it is endemic, such as Southeast Asia, EBV is typically associated with nasopharyngeal carcinoma. The incidence of such malignancies in the young population is unusual. Here we report a 17-year-old with a 5-year history of a painless right submandibular mass presenting with a sudden increase in size for one month before surgery. Neck examination revealed a firm right submandibular gland measuring five by five cm, with an irregular surface, non-tender with normal overlying skin. We performed a fine needle aspiration cytology (FNAC), and he underwent computed tomography (CT) scan of the neck. He underwent a right submandibulectomy. Lymph nodes from levels I and II were also removed. The final histopathology was reported as LEC. Following this tissue diagnosis, another follow-up surgery, a modified radical neck dissection, was carried out for locoregional clearance. Postoperatively, he completed chemoradiotherapy treatment and is now on regular follow-up.
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Affiliation(s)
- Azlan Iskandar Ishak
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), 43400 Serdang, Selangor Malaysia
| | - Lai Shau Kong
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Malaysia
| | - Mohd Razif Md Yunus
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Canselor Tuanku Muhriz UKM, Wilayah Persekutuan Kuala Lumpur, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Malaysia
| | - Mohd Zulkiflee Abu Bakar
- Department of Otorhinolaryngology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
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Shechter O, Sausen DG, Gallo ES, Dahari H, Borenstein R. Epstein-Barr Virus (EBV) Epithelial Associated Malignancies: Exploring Pathologies and Current Treatments. Int J Mol Sci 2022; 23:14389. [PMID: 36430864 PMCID: PMC9699474 DOI: 10.3390/ijms232214389] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
Epstein-Barr virus (EBV) is one of eight known herpesviruses with the potential to infect humans. Globally, it is estimated that between 90-95% of the population has been infected with EBV. EBV is an oncogenic virus that has been strongly linked to various epithelial malignancies such as nasopharyngeal and gastric cancer. Recent evidence suggests a link between EBV and breast cancer. Additionally, there are other, rarer cancers with weaker evidence linking them to EBV. In this review, we discuss the currently known epithelial malignancies associated with EBV. Additionally, we discuss and establish which treatments and therapies are most recommended for each cancer associated with EBV.
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Affiliation(s)
- Oren Shechter
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, USA
| | - Daniel G. Sausen
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, USA
| | - Elisa S. Gallo
- Tel-Aviv Sourasky Medical Center, Division of Dermatology, Tel-Aviv 6423906, Israel
| | - Harel Dahari
- The Program for Experimental and Theoretical Modeling, Division of Hepatology, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
| | - Ronen Borenstein
- The Program for Experimental and Theoretical Modeling, Division of Hepatology, Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, USA
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8
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Zhang C, Gu T, Tian Z, Wang L, Han J, Hu Y, Xia R, Li J. Lymphoepithelial carcinoma of the parotid gland: Clinicopathological analysis of 146 cases from a single institute. Head Neck 2022; 44:2055-2062. [PMID: 35915861 DOI: 10.1002/hed.27083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Parotid lymphoepithelial carcinoma (LEC) is a rare malignant tumor. The purpose of this study was to investigate the clinicopathological features of parotid LEC. METHODS All patients clinicopathological information diagnosed parotid LEC from 2005 to 2017 were analyzed. RESULTS A total of 146 cases of parotid LECs were identified. Of these, 126 (86.3%) were primary and 20 (13.7%) were secondary LECs. Patients with secondary LEC tended to have tumors with earlier TNM staging than those with primary (p = 0.031). The tumor cells in 87 (94.6%, 87/92) cases tested positive for Epstein-Barr virus (EBV). Cervical node metastases were present at diagnosis in 46 (31.5%) cases. Overall survival at 5 and 10 years was 97.0% and 90.8%, respectively. Older age was an adverse prognostic indicator for overall survival (p < 0.001). CONCLUSIONS Parotid LEC is associated with EBV and an increased rate of cervical node metastases. However, most patients, especially younger ones, have a good prognosis.
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Affiliation(s)
- Chunye Zhang
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ting Gu
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhen Tian
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Lizhen Wang
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jing Han
- National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China.,Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhua Hu
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ronghui Xia
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jiang Li
- Department of Oral Pathology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 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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10
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Rose EC, Tse TY, Oates AW, Jackson K, Pfeiffer S, Donahoe SL, Setyo L, Barrs VR, Beatty JA, Pesavento PA. Oropharyngeal Shedding of Gammaherpesvirus DNA by Cats, and Natural Infection of Salivary Epithelium. Viruses 2022; 14:v14030566. [PMID: 35336972 PMCID: PMC8950464 DOI: 10.3390/v14030566] [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] [Received: 01/31/2022] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 12/02/2022] Open
Abstract
Felis catus gammaherpesvirus-1 (FcaGHV1), a novel candidate oncogenic virus, infects cats worldwide. Whether the oropharynx is a site of virus shedding and persistence, and whether oronasal carcinomas harbor FcaGHV1 nucleic acid were investigated. In a prospective molecular epidemiological study, FcaGHV1 DNA was detected by cPCR in oropharyngeal swabs from 26/155 (16.8%) of cats. Oropharyngeal shedding was less frequently detected in kittens ≤3 months of age (5/94, 5.3%) than in older animals; >3 months to ≤1 year: 8/26, 30.8%, (p = 0.001, OR 7.91, 95% CI (2.320, 26.979)); >1 year to ≤6 years: 10/20, 50%, (p < 0.001, OR 17.8 95% CI (5.065, 62.557)); >6 years: 3/15, 33% (p = 0.078). Provenance (shelter-owned/privately owned) was not associated with shedding. In situ hybridization (ISH) identified FcaGHV1-infected cells in salivary glandular epithelium but not in other oronasal tissues from two of three cats shedding viral DNA in the oropharynx. In a retrospective dataset of 11 oronasopharyngeal carcinomas, a single tumor tested positive for FcaGHV1 DNA by ISH, a papillary carcinoma, where scattered neoplastic cells showed discrete nuclear hybridization. These data support the oronasopharynx as a site of FcaGHV1 shedding, particularly after maternal antibodies are expected to decline. The salivary epithelium is identified as a potential site of FcaGHV1 persistence. No evidence supporting a role for FcaGHV1 in feline oronasal carcinomas was found in the examined tumours.
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Affiliation(s)
- Elizabeth C. Rose
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, UC Davis, Davis, CA 95616, USA; (E.C.R.); (T.Y.T.); (A.W.O.); (K.J.); (P.A.P.)
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | - Tiffany Y. Tse
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, UC Davis, Davis, CA 95616, USA; (E.C.R.); (T.Y.T.); (A.W.O.); (K.J.); (P.A.P.)
| | - Andrew W. Oates
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, UC Davis, Davis, CA 95616, USA; (E.C.R.); (T.Y.T.); (A.W.O.); (K.J.); (P.A.P.)
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Ken Jackson
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, UC Davis, Davis, CA 95616, USA; (E.C.R.); (T.Y.T.); (A.W.O.); (K.J.); (P.A.P.)
| | - Susanne Pfeiffer
- Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China;
| | - Shannon L. Donahoe
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia; (S.L.D.); (L.S.); (V.R.B.)
| | - Laura Setyo
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia; (S.L.D.); (L.S.); (V.R.B.)
- Department of Pathology and Infectious Diseases, School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, UK
| | - Vanessa R. Barrs
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia; (S.L.D.); (L.S.); (V.R.B.)
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
- Centre for Animal Health and Welfare, City University of Hong Kong, Hong Kong, China
| | - Julia A. Beatty
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia; (S.L.D.); (L.S.); (V.R.B.)
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, China
- Centre for Animal Health and Welfare, City University of Hong Kong, Hong Kong, China
- Correspondence:
| | - Patricia A. Pesavento
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, UC Davis, Davis, CA 95616, USA; (E.C.R.); (T.Y.T.); (A.W.O.); (K.J.); (P.A.P.)
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11
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Abstract
Ectopic thymic carcinomas are rarely diagnosed in the thyroid gland, let alone in extrathyroid tissues. In the currently available literature, only five cases of extrathyroidal malignancies with thymic differentiation have been reported as arising in the major salivary glands. A 69-year-old female presented with a slow-growing palpable mass in the left parotid gland. Fine needle aspiration biopsy suggested metastatic cancer, whereas core needle biopsy revealed high-grade squamous cell carcinoma. The patient underwent left radical parotidectomy with selective ipsilateral lymph node dissection and subsequent radiation therapy. The surgical specimen was taken for histopathological examination. Microscopically, the tumor resembled thymic carcinoma. It was composed of large nests of squamoid cells with smooth contours, focally with a syncytial growth pattern, and accompanied by abundant lymphocytes with reactive lymphoid follicles. This appearance resembled a micronodular thymic carcinoma with lymphoid hyperplasia. Moreover, the tumor displayed expression of squamous markers (p40 and p63) and markers of thymic carcinoma (CD5 and CD117). Therefore, the final diagnosis of intrasalivary thymic carcinoma was rendered. The molecular analysis including next-generation sequencing demonstrated no variants of the strong, potential, or unknown clinical significance. The patient remains disease-free at 1-year follow-up. In the current case, we comprehensively present a clinical, microscopic, molecular, and radiological picture of CD5-positive squamous cell carcinoma of the parotid. We postulate that similar cases should be designated as intrasalivary thymic carcinoma analogically to similar thyroid tumors. Our case and the limited literature data indicate they should be distinguished from conventional squamous cell carcinoma of major salivary glands due to their rather favorable prognosis.
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12
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Picon H, Guddati AK. Analysis of Trends in Mortality in Patients with Lymphoepithelial Carcinoma of the Head and Neck. Int J Gen Med 2021; 14:6245-6250. [PMID: 34616177 PMCID: PMC8488143 DOI: 10.2147/ijgm.s299145] [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: 12/25/2020] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background Squamous cell carcinoma is the most common subtype of malignancy found in patients with head and neck malignancy. There are other rare subtypes which are not adequately reported in medical literature. Lymphoepithelial carcinoma consists of lymphocytic infiltration in a background of undifferentiated carcinoma. They are most often seen in salivary glands but can also be found in other structures of the head and neck region. This analysis reports the nation-wide mortality of patients diagnosed with lymphoepithelial carcinoma of the head and neck. Methods Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) Database from the years 2000 to 2014. Incidence-based mortality for all stages was queried and results were grouped by gender and race (Caucasian/White, African American/Black, American Indian/Alaskan native and Asian/Pacific Islander). Paired T-test was used to determine statistically significance difference between various subgroups. Results Incidence-based mortality has been improving for African American/Black patients and has been worsening for Caucasian/White, American Indian/Alaskan native and Asian/Pacific Islander for the period of 2000 to 2014. The differences in mortality trends were statistically different (P < 0.05). The highest mortality rate per 1000 patients was seen in Asian/Pacific Islander population, followed by African American/Black, American Indian/Alaskan native and the least mortality was noted in Caucasian/White patients. When a similar analysis with linearized trend lines on gender was conducted, only African American/Black males and Asian/Pacific Islander females showed an improving trend in mortality. The sample size was a major limitation of this study (Caucasian/White - 134, African American/Black - 30, American Indian/Alaskan native - 5 and Asian/Pacific Islander - 87). Conclusion Lymphoepithelial carcinoma is a rare subtype of head and neck malignancies whose incidence-based mortality showed a worsening trend. This study showed significant race and gender disparity amongst patients with lymphoepithelial carcinoma. Due to its rarity, this subtype warrants further study, especially with regards to its etiology, clinical course and cure rates.
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Affiliation(s)
- Hector Picon
- Medical College of Georgia, Augusta University, Augusta, GA, 30909, USA
| | - Achuta Kumar Guddati
- Division of Hematology/Oncology, Georgia Cancer Center, Augusta University, Augusta, GA, 30909, USA
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13
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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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14
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Kerns A, Ross A, Sugihara EM, Bathula SS. Tumors of Atypical Carcinoma of the Parotid Gland and Papillary Thyroid Carcinoma: A Case Report. Cureus 2020; 12:e10496. [PMID: 32963922 PMCID: PMC7500745 DOI: 10.7759/cureus.10496] [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: 11/16/2022] Open
Abstract
Lymphoepithelial carcinoma (LEC) is a variant of anaplastic carcinoma usually found in the nasopharynx. It is a rare, aggressive malignant tumor in the salivary glands, which is usually associated with Epstein-Barr virus (EBV), and often presents with facial nerve paralysis when in the parotid gland. This case report is unique in that our patient had EBV-negative LEC, with facial nerve involvement and a concurrent primary papillary thyroid carcinoma (PTC). We successfully managed this patient with surgery and adjuvant chemoradiotherapy. The patient has responded well to the treatment and she showed no evidence of disease at the 24-month follow-up.
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Affiliation(s)
- Aileen Kerns
- Department of Otolaryngology-Head and Neck Surgery, Detroit Medical Center, Detroit, USA
| | - Andrew Ross
- Department of Otolaryngology-Head and Neck Surgery, Detroit Medical Center, Detroit, USA
| | - Eric M Sugihara
- Department of Otolaryngology-Head and Neck Surgery, Detroit Medical Center, Detroit, USA
| | - Samba Siva Bathula
- Department of Otolaryngology-Head and Neck Surgery, Detroit Medical Center/Michigan State University, Detroit, USA
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15
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Whelan A, Al-Sayed AA, Bullock M, Taylor SM. Primary parotid lymphoepithelial carcinoma: A case report and literature review of a rare pathological entity. Int J Surg Case Rep 2020; 72:610-614. [PMID: 32698300 PMCID: PMC7332494 DOI: 10.1016/j.ijscr.2020.06.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022] Open
Abstract
A high index of suspicion is required for primary parotid lymphoepithelial cancer in Caucasians with a pre-auricular mass. LEC can afflict patients of any ethnicity in Epstein-Barr Virus non-endemic areas. LEC of the parotid gland is a rare entity that requires complete surgical resection and post-operative radiation therapy.
Background Lymphoepithelial carcinoma (LEC) of the salivary glands is a rare, but distinct, poorly-differentiated neoplasm that resembles undifferentiated nasopharyngeal carcinomas (NPC). Among primary salivary gland LECs, they most commonly arise in the parotid gland. These lesions have a noticeable racial predilection, mostly occurring in Asians and Arctic region native populations. They are strongly associated with Epstein-Barr virus (EBV), and are more common in EBV-endemic areas. The most common presenting symptoms of primary parotid LEC are parotid mass development and cervical lymphadenopathy. We report an unusual case of EBV-negative LEC in a Canadian Caucasian woman. Case presentation A 40-year-old female from Atlantic Canada presented with a rapidly enlarging preauricular mass and cervical lymphadenopathy. Preoperative diagnostics via radiology and fine needle aspiration alluded to an ambiguous primary parotid malignancy. She underwent a total parotidectomy with facial nerve sacrifice and ipsilateral selective neck dissection. The facial nerve was reconstructed with a lateral antecubital nerve graft. Pathology came back positive for LEC, and she began adjuvant radiotherapy. At her 1-year follow up, she was disease-free and obtained a House-Brackmann facial nerve function grade of 3. Conclusions The case report highlights the importance of having a high index of suspicion and the need for interdisciplinary collaboration in reaching the diagnosis of primary parotid LEC. LEC can afflict patients of any ethnicity in non-EBV endemic areas and should therefore be considered in all patients with a painless parotid mass regardless of ethnicity. Further studies are required to elucidate the oncogenic role of EBV in these cancers.
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Affiliation(s)
- Ashley Whelan
- Faculty of Medicine, Dalhousie University, 5849 University Ave, Halifax, NS B3H 4R2, Canada; Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS B3K 6R8, Canada.
| | - Ahmed A Al-Sayed
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS B3K 6R8, Canada; Department of Otolaryngology Head and Neck Surgery, King Saud University, King Abdul Aziz Rd, Al Malaz, Riyadh 12629, Saudi Arabia
| | - Martin Bullock
- Department of Pathology, Dalhousie University, Sir Charles Tupper Medical Building, Room 11B, 5850 College Street, Halifax, NS B3H 4R2, Canada
| | - S Mark Taylor
- Division of Otolaryngology Head and Neck Surgery, Department of Surgery, Dalhousie University, 5850 University Avenue, Halifax, NS B3K 6R8, Canada
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16
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Cytologic Clues to the Diagnosis of Lymphoepithelioma-Like Carcinoma of Parotid Gland with Possible Therapeutic Implications. Indian J Surg Oncol 2019; 10:374-376. [PMID: 31168265 DOI: 10.1007/s13193-018-0864-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022] Open
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17
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Darrason M, Martin A, Soussan M, Chouahnia K, Pailler MC, Boudabous H, Brillet PY, Bousquet G, Zelek L, Duchemann B. Immunotherapy for LELC: Case Report and a Focused Review. Clin Lung Cancer 2018; 20:e393-e401. [PMID: 30691964 DOI: 10.1016/j.cllc.2018.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/15/2018] [Accepted: 12/10/2018] [Indexed: 12/28/2022]
Abstract
Lymphoepithelioma-like carcinoma of the lung (LELC) is a rare, Epstein-Barr virus-associated tumor. LELC occurs mostly in young, Asian nonsmokers. A few hundred cases have been reported, mostly from retrospective Asian studies. Optimal treatment has not been clearly established. Treatment options are based on surgery for early stage and on cisplatin-based chemotherapy as first-line therapy for metastatic disease. Prognosis may seem better than for other types of non-small-cell lung cancer, but it remains poor in advanced disease, with a median survival of 24 months, and new treatments options are still warranted. Immunotherapies are now key players in the treatment of non-small-cell lung cancer. However, few data are available for this rare histologic subgroup. We have reviewed the available data on LELC with a focus on the first few cases reported with a response to a programmed cell death 1 inhibitor.
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Affiliation(s)
- Marie Darrason
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Antoine Martin
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Michael Soussan
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Kader Chouahnia
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Marie-Christine Pailler
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Hanene Boudabous
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Pierre-Yves Brillet
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Guilhem Bousquet
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Laurent Zelek
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France
| | - Boris Duchemann
- Oncologie Médicale, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Bobigny Laboratoire d'Oncoim, Oncology, Bobigny, France.
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18
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PIK3CA and p53 Mutations by Next Generation Sequencing in Lymphoepithelioma-Like Carcinoma of the Endometrium. Case Rep Pathol 2018; 2018:5894589. [PMID: 29854528 PMCID: PMC5960570 DOI: 10.1155/2018/5894589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/28/2018] [Indexed: 02/06/2023] Open
Abstract
Lymphoepithelioma-like carcinoma of the endometrium is a very rare variant of endometrial carcinoma characterized by syncytial nests of pleomorphic epithelial cells and heavy infiltration of the stroma by lymphocytes (in particular CD8 cytotoxic T-lymphocytes) and plasma cells. Until now, only five cases have been characterized in this location. This report describes the clinicopathological and the molecular features of this unusual tumor. In particular, using the next generation sequencing (NGS) technique, we have demonstrated that this tumor could be associated with PIK3CA and p53 gene mutations. These data have not been reported to date and suggest that lymphoepithelioma-like carcinoma of the endometrium shares common molecular features with high grade endometrioid and serous-like endometrial carcinoma which are associated with poor outcome. Nevertheless, in endometrial lymphoepithelioma-like carcinoma, the alterations on cell cycle, apoptosis, and/or senescence secondary to p53 mutations could potentially be counterbalanced by the antitumoral response induced by CD8 cytotoxic T-lymphocytes numerous in these tumors.
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19
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Guidry JT, Birdwell CE, Scott RS. Epstein-Barr virus in the pathogenesis of oral cancers. Oral Dis 2018; 24:497-508. [PMID: 28190296 PMCID: PMC5554094 DOI: 10.1111/odi.12656] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 12/28/2022]
Abstract
Epstein-Barr virus (EBV) is a ubiquitous gamma-herpesvirus that establishes a lifelong persistent infection in the oral cavity and is intermittently shed in the saliva. EBV exhibits a biphasic life cycle, supported by its dual tropism for B lymphocytes and epithelial cells, which allows the virus to be transmitted within oral lymphoid tissues. While infection is often benign, EBV is associated with a number of lymphomas and carcinomas that arise in the oral cavity and at other anatomical sites. Incomplete association of EBV in cancer has questioned if EBV is merely a passenger or a driver of the tumorigenic process. However, the ability of EBV to immortalize B cells and its prevalence in a subset of cancers has implicated EBV as a carcinogenic cofactor in cellular contexts where the viral life cycle is altered. In many cases, EBV likely acts as an agent of tumor progression rather than tumor initiation, conferring malignant phenotypes observed in EBV-positive cancers. Given that the oral cavity serves as the main site of EBV residence and transmission, here we review the prevalence of EBV in oral malignancies and the mechanisms by which EBV acts as an agent of tumor progression.
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Affiliation(s)
- Joseph T. Guidry
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
| | - Christine E. Birdwell
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
| | - Rona S. Scott
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
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20
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Halder A, Sommerville J, Gandhi M. Primary lymphoepthelial carcinoma of the parotid gland, pictorial review of a rare entity. J Med Imaging Radiat Oncol 2018; 62:355-360. [DOI: 10.1111/1754-9485.12735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/15/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Arani Halder
- Princess Alexandra Hospital; Brisbane Queensland Australia
- Faculty of Health Sciences and Medicine; Bond University; Gold Coast Queensland Australia
| | - Jennifer Sommerville
- Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
- Faculty of Medicine and Biomedical Sciences; University of Queensland; Brisbane Queensland Australia
| | - Mitesh Gandhi
- Princess Alexandra Hospital; Brisbane Queensland Australia
- Radiology; Queensland X-Ray; Brisbane Queensland Australia
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21
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Mezei T, Mocan S, Ormenisan A, Baróti B, Iacob A. The value of fine needle aspiration cytology in the clinical management of rare salivary gland tumors. J Appl Oral Sci 2018; 26:e20170267. [PMID: 29489937 PMCID: PMC5829550 DOI: 10.1590/1678-7757-2017-0267] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/18/2017] [Indexed: 12/20/2022] Open
Abstract
Salivary gland tumors are relatively rare neoplasms, mostly located in the parotid gland, and few are malignant. Preoperative evaluation of salivary gland tumors includes fine needle aspiration cytology (FNAC).
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Affiliation(s)
- Tibor Mezei
- Mures County Emergency Clinic, Department of Pathology, University of Medicine and Pharmacy of Tirgu Mures, Tirgu Mures, Romania
| | - Simona Mocan
- Mures County Emergency Clinic, Department of Pathology, University of Medicine and Pharmacy of Tirgu Mures, Tirgu Mures, Romania
| | - Alina Ormenisan
- Mures County Emergency Clinic, Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy of Tirgu Mures, Tirgu Mures, Romania
| | - Beáta Baróti
- Mures County Emergency Clinic, Department of Radiology, University of Medicine and Pharmacy of Tirgu Mures, Tirgu Mures, Romania
| | - Alina Iacob
- Mures County Emergency Clinic, Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy of Tirgu Mures, Tirgu Mures, Romania
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22
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Primary lymphoepithelial-like carcinoma of the parotid gland-case presentation. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background/Aim: Primary Lymphoepithelial carcinoma (PLEC) is a rare subtype of salivary gland cancers, which comprises only 0.4% of salivary malignant neoplasms and only a few cases have been presented previously. Case report: A patient with PLEC of the parotid gland, its management and the available literature are presented. A 53-year-old woman with initial lesion of a lump in the region of the right parotid received treatment with antibiotics which did not lead to improvement. MRI was performed that recorded the presence of a tumor in the right parotid gland and the patient subsequently underwent excision biopsy. The histopathological evaluation together with additional immunohistochemical positive staining of EMA+, EGFR+, p63+, CK 5/6+, AE1/AE3+ established the diagnosis of PLEC. A PET-CT scanning has shown nor primary mucosal source neither skin lesion to account for any possible metastatic disease, consequently a course of adjuvant post-operative radiotherapy to the region of the right parotid gland was performed. Conclusions: In the differential diagnosis of a parotid gland lump should be included the possibility of a rare salivary gland neoplasm such as PLEC. Surgical excision and radiotherapy have been proposed for the treatment of early and advanced neoplasm stages. Ages of the patient, stage of the neoplasm as well as type of therapy are significant and individual variables for the prediction of the prognosis.
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23
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Yao L, Zhang Y, Chen Q, Wang S, Wang Q, Yi J, Zhang L, Matz EL, Hu X, Huang G. Diagnosis of lymphoepithelial carcinoma in parotid gland with three dimensional computed tomography angiography reconstruction: A case report. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2018; 26:155-164. [PMID: 29480238 DOI: 10.3233/xst-17347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Lymphoepithelial carcinoma (LEC) is an uncommon malignant neoplasm. Due to the complicated anatomical structure of the human head, standard imaging modalities including ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scan remain limited in detection of salivary tumors. We used three-dimensional computed tomography angiography (3D-CT angiography) for the assessment and pre-operative surgical planning of facial fractures of a case with LEC. The study results demonstrated that 3D-CT angiography provided an insightful approach to preoperative evaluation in the treatment of salivary tumors.
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Affiliation(s)
- Li Yao
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Yuanyuan Zhang
- Wake Forest Institute for Regenerative Medicine, School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Qijun Chen
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Shuai Wang
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Qingjian Wang
- Department of Medical Image, Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Jie Yi
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Ligang Zhang
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Ethan L Matz
- Wake Forest Institute for Regenerative Medicine, School of Medicine, Wake Forest University, Winston-Salem, NC, USA
| | - Xiaohua Hu
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
| | - Guilin Huang
- Stomatological Hospital Affiliate to Zunyi Medical University, Guizhou, China
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24
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Kumar V, Dave V, Harris J, Huang Y. Response of advanced stage recurrent lymphoepithelioma-like carcinoma to nivolumab. Immunotherapy 2017; 9:955-961. [PMID: 28971752 DOI: 10.2217/imt-2017-0067] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Lymphoepithelioma-like carcinoma (LELC) of lung is a rare tumor that is mostly reported in south-east Asian countries. The surgical removal is curative in the early stages but there is no consensus on the choice of chemotherapy for the treatment of advanced stage tumors. Most of the data on chemotherapy are based on small case series and retrospective studies. As per available data, this tumor responds to chemotherapy initially but recurrences are common. The use of conventional chemotherapy in recurrent tumors leads to cumulative toxicities in the long term. Due to lack of actionable mutations, targeted therapies are also not very useful. Immune check point inhibitors immune checkpoint inhibitors have shown survival benefit in patients with advanced stage non-small-cell and small cell carcinoma with better side effect profile than conventional chemotherapy. The role of immune checkpoint inhibitors in LELC is unknown. Though several studies have reported high expression of programmed cell death-1 (PD-1)/or its -ligand (PD-L1) in LELC providing a rationale for trial of these agents, the actual benefit of these agents in LELC has not been reported so far. In this case series, we report two cases of advanced stage LELC that progressed despite multiple lines of chemotherapy but responded favorably to a PD-1 inhibitor, nivolumab.
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Affiliation(s)
- Vivek Kumar
- Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Vishangi Dave
- Hematology & Oncology, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Jonathan Harris
- Department of Pathology, Maimonides Medical Center, Brooklyn, NY 11219, USA
| | - Yiwu Huang
- Hematology & Oncology, Maimonides Medical Center, Brooklyn, NY 11219, USA
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25
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Zhan KY, Nicolli EA, Khaja SF, Day TA. Lymphoepithelial carcinoma of the major salivary glands: Predictors of survival in a non-endemic region. Oral Oncol 2016; 52:24-9. [DOI: 10.1016/j.oraloncology.2015.10.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/02/2015] [Accepted: 10/19/2015] [Indexed: 11/30/2022]
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26
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Muthayam SR, Kaushik R, Pushpanshu K, Singh KT, Raj V, Kumar B. Lymphoepithelial carcinoma arising from the maxillary antrum: a clinicopathological report of a rare lesion in an unusual site. Quant Imaging Med Surg 2014; 4:512-5. [PMID: 25525589 DOI: 10.3978/j.issn.2223-4292.2014.07.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 07/04/2014] [Indexed: 01/28/2023]
Abstract
Lymphoepithelial carcinoma (LEC) of the maxillary sinus is an exceedingly rare malignancy. It may be asymptomatic or present with non-specific obstructive nasal symptoms which makes its pre-operative diagnosis very challenging. This report describes our clinical and radiological findings in a 45-year-old Indian female patient with locally-advanced LEC of the right maxillary antrum. Histopathological and immunohistochemical results are also discussed. The case was effectively managed by external beam radiotherapy and the patient has remained disease-free at 20-month follow-up.
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Affiliation(s)
- Santan Reddy Muthayam
- 1 Department of Oral Medicine & Radiology, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 2 Department of Dentistry, SriKrishna Medical College & Hospital, Muzaffarpur, India ; 3 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 4 Department of Oral Pathology, Saraswati Dental College, Lucknow, India ; 5 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India
| | - Rachna Kaushik
- 1 Department of Oral Medicine & Radiology, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 2 Department of Dentistry, SriKrishna Medical College & Hospital, Muzaffarpur, India ; 3 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 4 Department of Oral Pathology, Saraswati Dental College, Lucknow, India ; 5 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India
| | - Kumar Pushpanshu
- 1 Department of Oral Medicine & Radiology, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 2 Department of Dentistry, SriKrishna Medical College & Hospital, Muzaffarpur, India ; 3 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 4 Department of Oral Pathology, Saraswati Dental College, Lucknow, India ; 5 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India
| | - Kumar Tathagat Singh
- 1 Department of Oral Medicine & Radiology, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 2 Department of Dentistry, SriKrishna Medical College & Hospital, Muzaffarpur, India ; 3 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 4 Department of Oral Pathology, Saraswati Dental College, Lucknow, India ; 5 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India
| | - Vineet Raj
- 1 Department of Oral Medicine & Radiology, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 2 Department of Dentistry, SriKrishna Medical College & Hospital, Muzaffarpur, India ; 3 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 4 Department of Oral Pathology, Saraswati Dental College, Lucknow, India ; 5 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India
| | - Bimleshwar Kumar
- 1 Department of Oral Medicine & Radiology, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 2 Department of Dentistry, SriKrishna Medical College & Hospital, Muzaffarpur, India ; 3 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India ; 4 Department of Oral Pathology, Saraswati Dental College, Lucknow, India ; 5 Department of Oral Surgery, Dr B R Ambedkar Institute of Dental Sciences & Hospital, Patna, India
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