Lymphoepithelioma-like hepatocellular carcinoma

Abstract

Rational:Lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) is a rare variant of hepatocellular carcinoma (HCC). To date, few cases have been reported in the literature, and almost no report in analyzing the different features of LEL-HCC.Patient concerns:We describe a 37-year-old female patient with a 32 × 30 mm mass in the right liver.Interventions:Complete surgical resection of the lesion was performed.Diagnoses:Histopathological examination of the resected tumor revealed undifferentiated HCC cells with significant lymphocytes infiltration. Immunohistochemically, the tumor cells were positive for AFP (alpha fetoprotein), hepatocyte, CK8, and glypican-3. The patient was diagnosed with LEL-HCC.Outcomes:The patient had a favorable clinical outcome, and was free from tumor recurrence after a 52-months follow-up.Lessons:Our case was the youngest patient of all the reported cases, and the third case who was infected with both hepatitis B virus (HBV) and hepatitis C virus (HCV). LEL-HCC is a rare variant of HCC, with a relatively favorable prognosis. Further research recruiting more patients is required to determine the accurate causes and mechanism of LEL-HCC.

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

“…Our patient was treated for HBV. There are reports in the literature that HBV and HCV infections may be an etiological factor for lymphoepithelioma-like hepatocellular carcinoma (LEL-HCC) [17, 18]. Imaging studies did not show any changes in the liver of our patient.…”

Synchronous hepatocellular carcinoma and lymphoepithelioma-like carcinoma arising from 2 different sites of the liver

“…In addition, positive results of CK7 and CK19 represent bile duct origin, with positive findings of 17% and 31%, respectively, in LEL-HCC cases and both 100% in LEL-CC cases. [ 3 , 8 ]…”

“…[ 10 ] Compared with conventional HCC, LEL-HCC is usually diagnosed at an early stage with a lower recurrent rate (5-year progression free survival: 87.8% versus 46.6%) as well as a favorable prognosis (5-year overall survival rate: 94.1% versus 63.9%) even with lymph node invasion. [ 3 , 4 , 6 , 8 ] It has been pointed out that the immune response against the tumor in LEL-HCC patients may be related to their survival benefit. [ 2 ] Further studies are needed to clarify this point.…”

“…[ 2 ] The histologic results, prognosis, and other features of LEL-HCC are quite different from the typical HCC, and the process of development of LEL-HCC remains unclear. [ 3 , 4 ] We present the first reported case of a surgical patient who had synchronous HCC and LEL-HCC arising from 2 different sites of the liver.…”

Pathologic and molecular features of hepatocellular carcinoma: An update

“…LEL-HCC morphologically resembles lymphoepithelioma-like carcinomas, a poorly differentiated epithelial tumor first described in nasopharynx, characterized by a prominent immune stroma/ microenvironment[ 4 ]. Subsequently it has been diagnosed in various organs such as stomach, colon, salivary glands, lungs, thymus, uterus, and ovaries[ 51 ]. These liver tumors are composed of poorly or undifferentiated neoplastic epithelial cells with a prominent lymphoid infiltrate[ 52 ].…”