Bhaumik Samapika, Singh Prarabdh, Reddy Narapareddy Venkata Dinesh, Jain Shreya, Nanda Sambit S, Paul Paramita, Mukherji Ashutosh, Pradhan Satyajit
Department of Radiation Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Center and Homi Bhabha Cancer Hospital, Varanasi 221005, India.
Department of Pathology, Mahamana Pandit Madan Mohan Malviya Cancer Center and Homi Bhabha Cancer Hospital, Varanasi 221005, India.
Ecancermedicalscience. 2025 Jun 27;19:1936. doi: 10.3332/ecancer.2025.1936. eCollection 2025.
Lympho-epithelial carcinoma (LEC) is most commonly found in the nasopharynx, while LEC of the hypopharynx and larynx is rare, with fewer than 50 cases in the published literature. As the non-nasopharyngeal presentations are rare, the clinical course, diagnosis and treatment for this tumour are sparsely reported. Here, we report a rare case report of Epstein-Barr virus negative laryngeal LEC treated with combined modality therapy in a tertiary care centre. We also review the literature regarding currently acceptable treatment strategies.
We present a case of a 59-year-old male who presented with hoarseness of voice and acute onset of respiratory distress. Post emergency tracheostomy for respiratory distress, evaluation with contrast-enhanced computed tomography head and neck revealed cT3N0M0 supraglottic disease. Biopsy revealed poorly differentiated carcinoma. In view of thyroid cartilage erosion, the patient underwent two cycles of neo-adjuvant chemotherapy followed by total laryngectomy, bilateral neck dissection and primary closure. Postoperative histopathology revealed ypT1N0 LEC, with adequate margins and adequate neck dissection. The patient was then treated with adjuvant chemoradiotherapy. 6 months follow-up positron emission tomography/computed comography shows no locoregional disease.
The treatment for rare cases like non-nasopharyngeal LEC is yet to be standardised. However, as seen in our case report, multimodality management including surgery, chemotherapy and radiation therapy seems to be a feasible approach to managing such rare cases of non-nasopharyngeal LEC.
淋巴上皮癌（LEC）最常见于鼻咽部，而下咽和喉部的LEC较为罕见，已发表文献中报道的病例不足50例。由于非鼻咽部表现罕见，关于该肿瘤的临床病程、诊断和治疗的报道较少。在此，我们报告一例在三级医疗中心接受综合治疗的爱泼斯坦-巴尔病毒阴性喉LEC罕见病例。我们还回顾了有关当前可接受治疗策略的文献。
我们报告一例59岁男性，表现为声音嘶哑和急性呼吸窘迫。因呼吸窘迫紧急行气管切开术后，对头颈部进行增强计算机断层扫描评估，显示声门上区cT3N0M0病变。活检显示为低分化癌。鉴于甲状腺软骨受侵，患者接受了两个周期的新辅助化疗，随后行全喉切除术、双侧颈清扫术和一期缝合。术后组织病理学显示ypT1N0 LEC，切缘足够，颈清扫充分。然后患者接受辅助放化疗。6个月的随访正电子发射断层扫描/计算机断层扫描显示无局部区域疾病。
像非鼻咽部LEC这样的罕见病例的治疗尚未标准化。然而，正如我们的病例报告所示，包括手术、化疗和放疗在内的多模式管理似乎是治疗此类非鼻咽部LEC罕见病例的可行方法。
