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Case Reports
. 2024 Jun 12:12:2050313X241260210.
doi: 10.1177/2050313X241260210. eCollection 2024.

Lymphoepithelial carcinoma of the parotid gland

Souha Kallel  1 , Sirine Ayadi  1 , Noura Salem  1 , Mouna Zghal  2 , Ben Ayed Mariem  1 , Lobna Ayedi  2 , Malek Mnejja  1 , Tahya Boudawara  2 , Ilhem Charfeddine  1
Affiliations
Case Reports

Lymphoepithelial carcinoma of the parotid gland

Souha Kallel et al. SAGE Open Med Case Rep. .

Abstract

Primary lymphoepithelial carcinoma of the salivary glands is an exceptional oncological condition that predominantly emerges within the parotid gland. A significant prevalence of lymphoepithelial carcinoma has been reported in the Inuit population, along with an associated positive serology for Epstein-Barr virus in these endemic regions. In this paper, we present a case of primary lymphoepithelial carcinoma of the parotid gland in a 68-year-old female patient with a history of diabetes and hypertension residing in a non-endemic area. Histology plays a critical role in the definitive diagnosis, and confirming the primary origin of lymphoepithelial carcinoma after ruling out metastasis from undifferentiated nasopharyngeal carcinoma. The mainstay of treatment is a combination of surgical resection and adjuvant radiotherapy. Inoperable forms are typically managed with chemoradiotherapy.

Keywords: EBV neoplasms; Lymphoepithelial carcinoma; malignant parotid neoplasms.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Magnetic resonance imaging (MRI) showing a right tumoral mass of the parotid. (a) T1-weighted sequence MRI frontal image showing the intracranial extension of the parotid tumor. (b) a T1-weighted sequence MRI axial image showing the infiltrating the right infra-temporal fossa by the parotid tumor.
Figure 2.
Figure 2.
Poorly defined tumor nests and sheets separated by fibrosis and infiltrating between the residual entrapped salivary ducts (HE 100× magnification).
Figure 3.
Figure 3.
Tumor cells with large atypical nuclei and poorly defined borders (syncytial appearance) intermixed with dense lymphoid stroma (HE 400× magnification).
Figure 4.
Figure 4.
Lymphoepithelial carcinoma with lymphocytic cell infiltration in and around tumor nests; note the presence of follicles (formula image) (HE 200× magnification).
Figure 5.
Figure 5.
(a) lymph node metastasis (formula image) of syncytial tumor sheets and accompanying lymphocytes (HE 200× magnification) (b) Epithelioid granuloma with Langerhans giant cells involving the lymph node (HE 200× magnification).
Figure 6.
Figure 6.
(a) Tumor cells stain positive for pancytokeratin (×100 magnification) (b) Immunostaining for p63 shows diffuse nuclear positivity in tumor cells (×100 magnification) (c) Positive staining for epithelial membrane antigen in the majority of tumor cells (×100 magnification) (d) Negative immunoreactivity for CK7 in tumor cells (×100 magnification).
Figure 7.
Figure 7.
(a) Negative staining of tumor cells for SMA (×200 magnification) (b) Negative staining of tumor cells for S-100 (×100 magnification) (c) High Ki 67 proliferation index (×200 magnification) (d) lymphocytes stain positive for CD20 with presence of follicles (formula image) (×100 magnification).
Figure 8.
Figure 8.
Immunostaining for pancytokeratin highlighting the tumor cells in the lymph node metastasis (×100 magnification).
See this image and copyright information in PMC

References

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