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Shoji MK, Sengillo JD, Abou Khzam R, Dubovy SR, Rong AJ. Lymphoepithelioma-like carcinoma of the eyelid and ocular adnexa. Orbit 2024; 43:140-146. [PMID: 35733412 DOI: 10.1080/01676830.2022.2085305] [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: 03/30/2022] [Accepted: 05/30/2022] [Indexed: 10/17/2022]
Abstract
A 93-year-old Caucasian woman presented to clinic for evaluation of a progressively enlarging left eyelid mass. Exam revealed a large, indurated, poorly mobile mass involving the left upper eyelid. Imaging demonstrated a crescentic enhancing soft-tissue mass in the left upper eyelid without evidence of deeper orbital involvement. Biopsy demonstrated tumor nests positive for cytokeratin AE1/AE3, P63, and P40 consistent with a diagnosis of eyelid lymphoepithelioma-like carcinoma (LELC). The patient underwent surgical resection with subsequent left upper eyelid reconstruction and adjuvant radiation. She had no clinical evidence of disease recurrence at follow-up. LELC is an uncommon tumor that rarely involves the eyelid and ocular adnexa. Early identification is important due to its malignant potential, as the majority of previously reported cases demonstrated local or distant metastatic spread. Future studies are needed to determine the optimum treatment regimen for this rare periorbital neoplasm.
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Affiliation(s)
- Marissa K Shoji
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jesse D Sengillo
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rayan Abou Khzam
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sander R Dubovy
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrew J Rong
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Maniglio S, Cazzato G, Caporusso C, Colagrande A, Nacchiero E, Maruccia M, Valerio J, Maiorano E, Resta L, Marzullo A, Giudice G, Ingravallo G. Poorly Differentiated Cutaneous Squamous Cell Carcinoma (cSCC) or Lymphoepithelioma-like Carcinoma of the Skin (LELCS) with Squamous Pearls: A Case Presentation with Emphasis on Histomorphological Features and Classification Debates. Life (Basel) 2023; 13:2265. [PMID: 38137866 PMCID: PMC10744854 DOI: 10.3390/life13122265] [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: 10/23/2023] [Revised: 11/23/2023] [Accepted: 11/26/2023] [Indexed: 12/24/2023] Open
Abstract
Lymphoepithelioma-like carcinoma of the skin (LELCS) is a rare primary skin cancer, with an annual incidence of 1/100,000 and about 85 cases published in the literature. It is considered the cutaneous counterpart of undifferentiated nasopharyngeal carcinoma (UNC, Schmincke-Regaud tumor) but has no association with EBV. We present an interesting case with features of LELCS in a 93-year-old man, right frontal-orbital region, diagnosed histologically and with immunohistochemical features. We also emphasize contrasting morphologic features for correct nosographic classification and address current issues, suggesting potential insights. Finally, we briefly reviewed other cases described in the literature.
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Affiliation(s)
- Sonia Maniglio
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
| | - Gerardo Cazzato
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
| | - Concetta Caporusso
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
| | - Anna Colagrande
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
| | - Eleonora Nacchiero
- Section of Plastic Surgery, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (E.N.); (M.M.); (G.G.)
| | - Michele Maruccia
- Section of Plastic Surgery, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (E.N.); (M.M.); (G.G.)
| | - Jacqueline Valerio
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
| | - Eugenio Maiorano
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
| | - Leonardo Resta
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
| | - Andrea Marzullo
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
| | - Giuseppe Giudice
- Section of Plastic Surgery, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (E.N.); (M.M.); (G.G.)
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy; (S.M.); (C.C.); (A.C.); (J.V.); (E.M.); (L.R.); (A.M.); (G.I.)
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Radiotherapy in lymphoepithelioma-like carcinoma of the skin: review of the literature and report of a recurrent and metastatic case. Strahlenther Onkol 2019; 195:1028-1032. [PMID: 31501980 PMCID: PMC6811378 DOI: 10.1007/s00066-019-01516-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/31/2018] [Indexed: 11/24/2022]
Abstract
Primary lymphoepithelioma-like carcinoma of the skin (LELCS) is a very rare cutaneous neoplasm. Only about 70 cases have been documented in the literature. There are no prospective data regarding treatment methods. Surgical excision is sufficient therapy in the majority of cases. Radiation therapy is sometimes used in case of recurrence or positive margins after surgery. The metastatic potential of LELCS is extremely low and only five previously documented cases of lymph node spread have been reported. We present the case of an 80-year-old male with a tumor primarily located on the lower eyelid, with two regional recurrences and cervical lymph node spread after surgery, treated with concurrent chemoradiation. According to the available data, this is the first case of lymph node spread from an eyelid location and the first nodal recurrence after surgery.
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Oliveira CC, Nóbrega VC, Marques MEA. Lymphoepithelioma-like carcinoma of the skin. An Bras Dermatol 2018; 93:256-258. [PMID: 29723365 PMCID: PMC5916400 DOI: 10.1590/abd1806-4841.20187205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 05/23/2017] [Indexed: 11/22/2022] Open
Abstract
Primary cutaneous lymphoepithelioma-like carcinoma is a rare disease with low metastatic potential. Its morphologic and pathological features are similar to those of nasopharyngeal lymphoepithelial carcinoma. We report the case of a 60-year-old man with an infrapalpebral pearly papule, measuring 0.6 cm in diameter. The lesion was excised with a clinical hypothesis of basal cell carcinoma or squamous cell carcinoma. Histopathological analysis revealed a malignant neoplasm with syncytial arrangement of cells with vesicular nuclei, associated with dense lymphocytic infiltrate. Immunohistochemistry revealed cytokeratin-positive cells (AE1/AE3) and p63 protein, indicating epithelial histogenesis and squamous differentiation. A negative Epstein-Barr virus test result was achieved by immunohistochemistry. Primary lymphoepithelioma-like carcinoma of the skin is a differential diagnosis of lesions with prominent inflammatory infiltrates.
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Affiliation(s)
- Cristiano Claudino Oliveira
- Department of Pathology of the Botucatu School of Medicine,
Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) -
Botucatu (SP), Brazil
| | - Vinicius Cardoso Nóbrega
- Department of Pathology of the Botucatu School of Medicine,
Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) -
Botucatu (SP), Brazil
| | - Mariângela Esther Alencar Marques
- Department of Pathology of the Botucatu School of Medicine,
Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) -
Botucatu (SP), Brazil
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Zolotareva EV, Andreeva YY, Frank GA. [Lymphoepithelioma-like tumors: A review of literature and a clinical case of bladder carcinoma]. Arkh Patol 2015; 77:55-62. [PMID: 26485781 DOI: 10.17116/patol201577455-62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The paper presents historical information and literature data on lymphoepitheliomas and lymphoepithelioma-like tumors at various sites. It considers the specific features of their histological structure, a differential diagnostic series, and immunohistochemical markers and gives brief information on treatment and prognosis. The paper depicts a clinical case of lymphoepithelioma-like bladder carcinoma in an 80-year-old woman.
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Affiliation(s)
- E V Zolotareva
- Department of Pathologic Anatomy, Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow
| | - Yu Yu Andreeva
- Department of Pathologic Anatomy, Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow
| | - G A Frank
- Department of Pathologic Anatomy, Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow
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Qiu B, Lin YB, Cai QQ, Hu YM, Wang DF, Lin ZD, Liang Y. Primary lymphoepithelioma-like carcinoma of ocular adnexa: clinicopathologic features and treatment. ACTA ACUST UNITED AC 2013; 20:e113-22. [PMID: 23559878 DOI: 10.3747/co.20.1289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND METHODS Lymphoepithelioma-like carcinoma (lelc) is a rare malignancy in ocular adnexa. Here, we report 4 patients with lelc and review 11 patients reported in the literature. Clinical profiles, association with Epstein-Barr virus (ebv), treatment, and outcomes are analyzed. RESULTS Lacrimal glands and the lacrimal drainage system, eyelid, and conjunctiva are potential primary sites for lelc. The tumours are characterized histologically by nests of undifferentiated malignant cells surrounded by lymphoid infiltrates. Infection with ebv was confirmed in lelc of ocular adnexa, and that association seemed to be restricted to Asian populations. Results from our centre uniformly showed expression of ebv-encoded small rnas in primary tumour, locally recurrent tumour, and metastatic lymph nodes. This disease had a tendency to relapse regionally. Postoperative radiotherapy seems to improve disease-free survival. Tumours appear to be sensitive to radiotherapy and chemotherapy based on cisplatin and 5-fluorouracil. At our centre, 3 patients were still living at 22, 33, and 76 months after surgery. One patient died of distant metastasis after a survival of 38 months. CONCLUSIONS Lymphoepithelioma-like carcinoma is a heterogenous entity among ocular adnexal malignancies. Multimodality treatment provides a better chance at survival. Further investigation is required to achieve a better understanding of the biologic behavior of this entity and of its optimal treatment.
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Affiliation(s)
- B Qiu
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China
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Welch PQ, Williams SB, Foss RD, Tomaszewski MM, Gupta A, Ojha J. Lymphoepithelioma-like carcinoma of head and neck skin: a systematic analysis of 11 cases and review of literature. ACTA ACUST UNITED AC 2010; 111:78-86. [PMID: 20952226 DOI: 10.1016/j.tripleo.2010.05.075] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 05/12/2010] [Accepted: 05/31/2010] [Indexed: 11/25/2022]
Abstract
Lymphoepithelioma-like carcinoma of the skin (LELCS) is a rare tumor of unknown etiology, low malignant potential, and microscopic resemblance to undifferentiated nasopharyngeal carcinoma. Clinically, it presents as a flesh-colored firm nodule or plaque on the face, scalp, or shoulder of middle-aged to elderly individuals. Histologically, LELCS is composed of islands of enlarged epithelial cells with large vesicular nuclei surrounded and permeated by a dense lymphoplasmacytic infiltrate. LELCS exhibits immunoreactivity with high-molecular-weight cytokeratins and epithelial membrane antigen, indicating the epithelial origin. The differential diagnosis includes basal cell carcinoma, squamous cell carcinoma, lymphoma, pseudolymphoma, and Merkel cell carcinoma. We report 11 cases of LELCS of the head and neck region with discussion of the clinical, histopathologic, immunohistochemical, and therapeutic aspects of this rare cutaneous neoplasm. In addition, we systematically review and compare the findings with the previously published cases of LELCS. This study is the largest case series of LELCS reported in the English-language literature. It attempts to more clearly define the diagnostic criteria for LELCS. Its histomorphologic and immunophenotypic features help distinguish this tumor from similar-appearing malignancies, including metastatic nasopharyngeal carcinoma.
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A case of lymphoepithelioma-like carcinoma of the skin associated with Epstein-Barr virus infection. J Am Acad Dermatol 2010; 62:681-4. [PMID: 20227583 DOI: 10.1016/j.jaad.2008.07.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2008] [Revised: 06/23/2008] [Accepted: 07/10/2008] [Indexed: 11/24/2022]
Abstract
Lymphoepithelioma-like carcinoma of the skin (LELCS) is a rare cutaneous neoplasm with histopathologic similarities to nasopharyngeal carcinoma. The association of nasopharyngeal carcinoma with Epstein-Barr virus (EBV) is well documented. EBV has also been reported to be associated with LELC in only four sites (the stomach, salivary glands, lung, and thymus), but not in the skin. We report herein a case of EBV-positive LELCS. An 82-year-old female presented with a red nodule on the right cheek. Histologically, the entire dermis was occupied by atypical tumor cell nests with dense lymphocytic infiltration. Neoplastic cells were strongly positive for cytokeratin 14 but were negative for cytokeratins 19 and 20. EBV genomes in neoplastic cells were detected by polymerase chain reaction analysis and in situ hybridization for EBV-encoded RNA, suggesting an association with EBV.
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Lyle P, Nakamura K, Togerson S. Lymphoepithelioma-like carcinoma arising in the scar from a previously excised basal cell carcinoma. J Cutan Pathol 2008; 35:594-8. [PMID: 18201243 DOI: 10.1111/j.1600-0560.2007.00852.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report a case of a primary lymphoepithelioma-like carcinoma of the skin (LELCS) associated with scar from a previous excision of basal cell carcinoma. The patient was a 68-year-old female with a 3.0 mm skin-colored pearly papule on her forehead that developed over 2-3 months. The patient had a history of a basal cell carcinoma in the same location, which was completely excised 1 year earlier. A biopsy and subsequent excision of the tumor were performed. The tumor consisted of small islands of large pleomorphic mitotically active epithelioid cells surrounded by a very dense lymphoplasmacytic infiltrate. The tumor was associated with dermal scar. There was no connection of tumor with the unremarkable epidermis. Immunohistochemical examination showed that the epithelioid tumor cells were positive for pan-cytokeratin and epithelial membrane antigen, supporting the morphologic impression of LELCS. The lesion was negative for Epstein-Barr virus. Retrospective review of the original excision specimen confirmed the diagnosis of an ordinary basal cell carcinoma. Forty-five cases of LELCS have been reported to date. We report the first case of LELCS to arise in the scar from an excision of a cutaneous malignancy.
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Affiliation(s)
- Pamela Lyle
- Department of Pathology, Penrose Hospital, Colorado Springs, CO, USA.
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