Year 2025 / Volume 117 / Number 8
Letter
Lymphoepithelioma-like carcinoma: a rare case of rectal cancer

469-470

DOI: 10.17235/reed.2024.10540/2024

David Luengo Gómez, Ángela Salmerón Ruíz, Javier Pastor Mena, Antonio Jesús Láinez Ramos-Bossini,

Abstract
Lymphoepithelioma-like carcinoma (LELC) is a histological variant that resembles nasopharyngeal lymphoepithelioma and occurs in various locations such as the salivary glands and lung. LELCs in the digestive tract are rare, accounting for only 2% of cases, being exceptional in the rectum. We present the case of an 84-year-old man with rectorrhagia, whitish malodorous discharge and constipation of one month's duration. Rectal examination identified a tumour. Colonoscopy revealed a rectal lesion that was confirmed by biopsy as malignant, and MRI showed an extensive rectal tumour. Histopathology revealed undifferentiated carcinoma with acute inflammatory infiltrate, consistent with LELC. Immunohistochemistry was positive for keratins 5/6, 18, 20, CEA and BER.EP4, while in situ hybridisation for Epstein-Barr virus (EBV) RNA was negative. The multidisciplinary decision included neoadjuvant radiotherapy and anterior rectal resection. The patient remains in complete response two years after treatment. Histologically, LELC is characterised by an acute inflammatory infiltrate interspersed with poorly differentiated neoplastic cells. The stomach is the most commonly affected region in the gastrointestinal tract, with more than 80% of gastric LELCs associated with EBV. To date, only four cases of rectal LELC have been reported, and its association with EBV was demonstrated in only one case. There are no standard treatments for rectal LELC, underscoring the need to gather more cases to understand its pathogenesis and develop effective treatment strategies.
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References
1. Zhai X, Liu J, Lu D, Zhou Q. Demographics, clinical features, and prognosis of rare lymphoepithelioma-like carcinoma across different anatomic sites. J Egypt Natl Canc Inst. 2022;34(1).
2. Kon S, Kasai K, Tsuzuki N, Nishibe M, Kitagawa T, Nishibe T, et al. Lymphoepithelioma-like carcinoma of rectum: possible relation with EBV. Pathol Res Pract. 2001;197(8):577–82.
3. Oi H, Yamamoto S, Kono Y, Masaki Y. A case of Lymphoepithelioma-like carcinoma (LELC) developed in the rectum. Rep Pract Oncol Radiother. 2019;24(6):624–8.
4. Kopparthy P, Chaffin J, Feely MM, Parekh HD. HPV-16-associated lymphoepithelial-like carcinoma mimicking rectal tonsil. Clin J Gastroenterol. 2021;14(3):810–4.
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Luengo Gómez D, Salmerón Ruíz Á, Pastor Mena J, Láinez Ramos-Bossini A. Lymphoepithelioma-like carcinoma: a rare case of rectal cancer. 10540/2024


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Publication history

Received: 15/05/2024

Accepted: 19/05/2024

Online First: 22/05/2024

Published: 24/07/2025

Article Online First time: 7 days

Article editing time: 435 days


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