Lymphoepithelioma-Like Carcinoma of the Skin in a Tunisian Patient

Abstract

Lymphoepithelioma-like carcinoma of the skin (LELCs) is a rare cutaneous neoplasm with histologic features resembling lymphoepitheliomatous tumors of the nasopharynx. The association of lymphoepitheliomas with Epstein-Barr Virus (EBV) at some extracutaneous sites is well documented. In contrast, the presence of EBV in LELCs has never been shown in either Caucasians or Asian patients. We present the first case of LELCs in a Tunisian patient, a 78-year-old woman who presented with a nodule of the right cheek of 2 months' duration. The patient underwent surgical excision and there was no evidence of local recurrence 6 months later. Histologically, the entire dermis was occupied by lobules composed of atypical epithelial cells surrounded by a dense lymphoplasmacytic infiltrate. Immunohistochemical examination showed that the epithelial tumor cells were positive for cytokeratin and epithelial membrane antigen. In situ hybridization investigations for the presence of EBV-encoded RNA showed negative results. Our findings suggest that LELCs is not related to EBV among North African patients.

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

“…Over time, there have been debates about the origin of LELCS, as well as the actual existence of this entity outside of cSCC variants. In this regard, Ho et al, in 2005 [9], hypothesized two theories that could explain the origin of this lesion; according to one interpretation, the origin would be considered epithelial, although in the cases reported in the literature, a connection with the overlying epidermis is never reported, while, on the other hand, since the first description of LELCS [4], it has been thought that it might have an adnexal origin [1,10,11]. In contrast, however, to its nasopharynx counterpart, only one case pub-lished so far has demonstrated positivity for EBV [6], with the presence of EBV-DNA in both Real-Time Polymerase Chain Reaction (RT-PCR) and ISH for EBV-encoded RNA (EBER), localized within the nuclei of the tumor cells.…”

Lymphoepithelioma-like carcinoma of the skin in a Polish patient

“…A wide local excision remains the first-line treatment, although radiotherapy is reserved for local recurrences or lymph nodes metastasis [ 8 ]. Mohs micrographic surgery has also been used as an alternative method to the traditional resection of the tumor [ 9 – 12 ].…”

“…The local recurrence rate was 10%. Only 2 patients developed lymph node metastases with a fatal outcome [ 12 ].…”

Merkel Cell Carcinoma with Lymphoepithelioma-Like Pattern: A Case Report of an Exceedingly Rare Variant of Merkel Cell Carcinoma with Lymph Node Metastases at Presentation

“…The first Tunisian case was reported only in 2006 [6]. Histologically, LEL carcinoma is indistinguishable from undifferentiated nasopharyngeal carcinoma—which is much more common—or other LEL carcinomas that develop in various parts of the body.…”