Alqurashi Nassar M, Alqurashi Thamer M, Hadaidi Wael A, Alsayed Abdullah H, Salman Ibrahim
Urology, Al-Hada Armed Forces Hospital, Taif, SAU.
Urology, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU.
Cureus. 2025 Jun 17;17(6):e86220. doi: 10.7759/cureus.86220. eCollection 2025 Jun.
Lymphoepithelioma-like carcinoma (LELC) of the bladder is a rare variant of urothelial carcinoma that histologically resembles lymphoepithelioma of the nasopharynx. Due to its rarity, prognostic outcomes and optimal treatment strategies remain unclear. We present the case of a 60-year-old male who presented with gross hematuria. Imaging revealed an anterior bladder wall mass. The patient underwent transurethral resection of a papillary lesion located at the bladder dome, with histopathological evaluation confirming LELC. He received neoadjuvant chemotherapy; however, follow-up cystoscopy revealed recurrence. A repeat endoscopic resection confirmed persistent disease, and the patient subsequently underwent partial cystectomy. Two follow-up cystoscopies showed no evidence of recurrence. Bladder LELC may present in pure, predominant, or focal forms, with prognosis influenced by the proportion of lymphoepithelial components. Immunohistochemistry is essential for diagnosis. Although Epstein-Barr virus has been associated with LELC in other sites, it has not been implicated in the bladder. Multimodal treatment, typically involving surgery and cisplatin-based chemotherapy, is commonly employed. In this case, partial cystectomy led to favorable short-term outcomes. Further research is needed to establish standardized treatment protocols.
膀胱淋巴上皮瘤样癌（LELC）是尿路上皮癌的一种罕见变体，其组织学表现类似于鼻咽癌的淋巴上皮瘤。由于其罕见性，预后结果和最佳治疗策略仍不明确。我们报告一例60岁男性，表现为肉眼血尿。影像学检查发现膀胱前壁肿块。患者接受了经尿道膀胱顶部乳头状病变切除术，组织病理学评估确诊为LELC。他接受了新辅助化疗；然而，随访膀胱镜检查发现复发。再次内镜切除证实疾病持续存在，随后患者接受了膀胱部分切除术。两次随访膀胱镜检查均未发现复发迹象。膀胱LELC可能以纯、为主或局灶形式出现，预后受淋巴上皮成分比例影响。免疫组织化学对诊断至关重要。虽然爱泼斯坦-巴尔病毒在其他部位与LELC有关，但在膀胱中尚未发现其关联。通常采用多模式治疗，通常包括手术和基于顺铂的化疗。在本病例中，膀胱部分切除术带来了良好的短期结果。需要进一步研究以建立标准化治疗方案。
