Bladder Lymphoepithelioma-Like Carcinoma: Case Report and Literature Review

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UrinaryLymphoepithelioma-like carcinoma are rare tumours classified according to Lymphoepithelioma component as pure (100%), predominant (≥50%) or focal (<50%), that is correlated with prognosis.We present here an original case of a 54 year-old man who was diagnosed with a high-grade T2 transitional cell carcinoma associated with LELC >50%. Four cycles of neoadjuvant gemcitabine and platinum-based chemotherapy were carried out with a good tolerance. After completed chemotherapy, the patient underwent a radical cyst prostatectomy with lymph nodes dissection and orthotropic urinary diversion. One year after surgery the patient remains free from relapse.

It’s difficult to define the optimal strategy, literature reporting only small series. Nevertheless, the benefit of chemotherapy is certain. The outcome is good in the pure and predominant forms and poorer in focal subtypes.Lymphoepithelioma-Like Carcinoma (LELC) is a rare tumour, which has a close link to Epstein-Barr virus. (EBV) It’s commonly found in nasal pharyngea, stomach, cervix, lung, hepatobiliary tract and ovary. Its occurrence in the urinary system is very rare. LELC of the urinary bladder was first described by Zuckerberg in 1991. It represents between 0,4 and 1,3% of all bladder cancers. These tumours are classified according to Lymphoepithelioma component as pure (100%), predominant (≥50%) or focal (<50%).

We present here an original case of a 54 year-old man who was diagnosed with a LELC of the urinary bladder and discuss its management regarding the lake of data in the literature. A 54 year-old Caucasian man presented few weeks history of haematuria associated with urinary frequency and dysuria. He had no medical history. He underwent surgery for discal hernia and appendicectomy a long time ago. He was a smoker since he was 15 year-old and stopped for fifteen years. He underwent transurethral resection for its bladder tumour. The results of histological examination confirmed a high-grade T2 transitional cell carcinoma with LELC >50%. On immunohistochemical staining the CKAE1/AE3, p53, was positive and CK7 and CD20 were negative.