Lymphoepithelioma-like Carcinoma of the Skin

Abstract

Summary:Lymphoepithelioma-like carcinoma of the skin is a rare, low malignant cutaneous neoplasm. We report a case of an elderly woman with lymphoepithelioma-like carcinoma of the skin in the forehead. The tumor was mistaken first as actinic keratosis and later as metastatic squamous cell carcinoma. A histological reassessment showed lymphoepithelioma-like carcinoma of the skin with perineural invasion, which is rare and considered more aggressive. The patient therefore received adjuvant radiotherapy after the recommended wide excision. Lymphoepithelioma-like carcinoma of the skin is a variant of squamous cell carcinoma, and histologically, it resembles the more aggressive lymphoepithelioma of the nasopharynx. The later is Epstein-Barr positive, whereas lymphoepithelioma-like carcinoma normally is not. Lymphoepithelioma-like carcinoma is an important diagnosis to know and the disease is discussed.

Radiotherapy in lymphoepithelioma-like carcinoma of the skin: review of the literature and report of a recurrent and metastatic case

“…Differential diagnosis should also exclude skin metastasis of Merkel cell carcinoma, squamous cell carcinoma, and lymphoma [3, 10].…”

“…[13] (2012)Adjuvant treatment after surgery—positive margins and perineural invasionConcurrent chemoradiotherapy—5 cycles of cisplatin (20 mg/m 2 ) and 60 Gy in 30 fractions to the tumor bed and to track the infra-orbital nerve2 years of follow-upLassen et al. [3] (2014)Adjuvant treatment after surgery—perineural invasion in re-excision51 Gy in 17 fractions in the operated area with margin of 1 cm2 years of follow-up…”

“…The tumor morphology bears numerous similarities to undifferentiated nasopharyngeal carcinoma; thus, every patient requires diagnostic assessment in order to exclude a metastatic character of the lesion. Surgical excision is the first-line treatment [3], and radiation therapy is also sometimes used in case of recurrence or positive margins after surgery. LELCS has an exceedingly low metastatic potential.…”

A rare mimic of basal cell carcinoma

“…However, LELCS is usually managed with conventional excision, as for our patient. Other treatment options include margin‐controlled excision and radiotherapy in the presence of perineural invasion or positive margins 4,5 . In our case, urgent excision of the residual lesion was arranged and histopathological examination revealed similar features to the initial biopsy.…”

Lymphoepithelioma-like Carcinoma of the Skin in the Cheek with a Malignant Metastatic Cervical Lymph Node

“…Although the histologic etiology of LELCS is still unclear, it is known to have a slight tendency toward local recurrence and extremely low metastatic potential. Approximately 70 cases have been reported in the literature to date [ 1 ]. Among them, only a few reports have described local recurrence or metastasis to lymph nodes, and only one reported death due to distant metastasis of LELCS.…”