Clinical silence of pulmonary lymphoepithelioma-like carcinoma with subcutaneous metastasis: a case report

Takafumi Shima,Nagahisa Fujio,Kazuhisa Uchiyama,Kohei Taniguchi,Yasutsugu Kobayashi,Shotaro Kakimoto

doi:10.1186/s12957-019-1671-z

Abstract

BackgroundDissemination of lung cancer to cutaneous sites usually results in a poor prognosis. Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare tumor, and no therapeutic strategy for it has yet been established. We present herein an extremely rare case of a long-term surviving patient with PLELC showing subcutaneous metastasis.Case presentationA 76-year-old woman was diagnosed unexpectedly as having PLELC based on a nodule on her back. After surgical resection of the primary and metastatic lesions, she has remained alive with no recurrence for over 5 years without any additional therapy.ConclusionEven in the case of PLELC with subcutaneous metastasis, surgical management may afford a prognosis of long-term survival.

Highlights

Dissemination of lung cancer to cutaneous sites usually results in a poor prognosis
The diagnosis of Pulmonary lymphoepithelioma-like carcinoma (PLELC) depends mainly on morphologic characteristics, which includes solid nests of tumor cells with prominent nucleoli in a syncytial arrangement surrounded by lymphocyte infiltrates
The presence of Epstein-Barr virusencoded RNA (EBER), latent membrane protein 1 (LMP1), and CD8-positive T lymphocytes suggest a relationship between Epstein-Barr virus (EBV) and the pathogenesis of the tumor [2]

Summary

Introduction

Dissemination of lung cancer to cutaneous sites usually results in a poor prognosis. Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare tumor, and no therapeutic strategy for it has yet been established. We report an extremely rare case of a long-term surviving patient having clinically silent PLELC with subcutaneous metastasis. Case presentation The patient was a 76-year-old Japanese woman with a primary complaint of a subcutaneous nodule in her back. Hematoxylin and eosin (HE) staining showed evidence of malignant spindle-cell proliferation (Fig. 1c).

Results

Conclusion