Lymphoepithelioma‑Like Cholangiocarcinoma with Hepatitis C Virus Infection Treated by Microwave Ablation: A Literature Review and Case Report

Abstract

Background: Lymphoepithelioma-like cholangiocarcinoma (LELCC) is a rare type of intrahepatic tumor that is poorly understood. It is not associated with specific physical findings and is usually diagnosed incidentally, resulting in tumors that are often large-sized at diagnosis. At present, the main treatment approach is surgical resection. Case Presentation: Here, we report the case of a patient with LELCC treated with microwave ablation (MWA). Our patient was a Chinese man with chronic hepatitis C and a 51 mm-diameter intrahepatic tumor. Despite blood testing, gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging, and abdominal ultrasound, the tumor was not well diagnosed. However, the histopathological findings of ultrasound-guided percutaneous tumor biopsy led to a diagnosis of LELCC. The patient was treated with MWA, and no new lesions had occurred at 9 months after treatment. Conclusion: To our knowledge, this is the first patient with LELCC treated using MWA. Our experience suggests that MWA is an effective new therapeutic method for this disease.

Combined NK-CIK and PD-1 inhibitor (nivolumab), an effective immunotherapy for treating intrahepatic lymphoepithelioma-like cholangiocarcinoma unassociated with EBV infection: Two case reports and a literature review

“…According to the literature, the size of the tumor varies from 0.8 cm to 12 cm. Patients with LELLC are diagnosed with a large tumor size due to the varying symptoms or unspecific imaging and laboratory tests ( 9 ). As of now, a total of 70 patients have presented immunohistochemical features ( Supplementary Table 2 ).…”

“…Considerable enhancement and washout were reported in the arterial phase, and it supported the hypervascular characteristic of LELCC ( 12 ). It was noted that the characteristics of LELCC were highly variable from each other, and the diagnosis would not be possible with the imaging features alone ( 9 ). It was also noted that there was a higher incidence of LELCC in the right lobe than in the left (R:L = 58:45).…”

“…Recently, Li et al. ( 9 ) reported a case of LELCC that was treated with microwave ablation that achieved patient overall survival for 9 months. This study revealed that 63.71% of the reported cases were alive with no signs of disease, while 15.9% were alive with neoplastic disease and 17.6% died during interventions or post-surgical complications.…”

An Epstein-Barr Virus Positive Lymphoepithelioma-Like Cholangiocarcinoma in A Young Woman with Chronic Hepatitis B Treated through Microwave Ablation: A Case Report and Literature Review

“…Some LELCCs are associated with EBV infection [6]. EBV-associated LELCC has a unique immune microenvironment and a better prognosis than typical ICC [1,3].…”

“…EBV-associated LELCC has a unique immune microenvironment and a better prognosis than typical ICC [1,3]. Since LELCC was first reported in 1996, most English language publications about LELCC have been case reports and case series [6,7]. Most of the patients whose cases were reported were from Asia, with a median age of 55 years, among whom there were more women than men.…”