ABSTRACT
Gastric lymphoepithelioma-like carcinoma is a very rare cancer of the stomach. It has undifferentiated malignant cells with rich lymphoid stroma histologically and its prognosis has known to be relatively fair. Recently, there were some reports on the successful removal of the lesion by endoscopic submucosal dissection technique. We present a case of 70 years old man who had 2 cm sized early gastric cancer of lymphoepithelioma-like carcinoma with perigastric lymph node metastasis, and also review the relevant medical literature.
Subject(s)
Lymph Nodes , Neoplasm Metastasis , Prognosis , Stomach NeoplasmsABSTRACT
Gastric lymphoepithelioma-like carcinoma is a rare carcinoma among gastric malignant tumor but has a good prognosis. The carcinoma has histologic feature characterized by small nest of cancer cells mixed with lymphoid stroma. We report a case with lymphoepithelioma-like carcinoma of stomach initially presenting as panperitonitis because of spontaneous tumor perforation. A 56-year-old man visited our emergency room because of epigastric pain. A preoperative abdominal CT scan showed a massive pneumoperitoneum in the upper abdomen, and the presence of gastric cancer in the lesser curvature of the stomach. An emergent laparotomy was performed followed by radical subtotal gastrectomy. Pathologic examination revealed that the tumor was a lymphoepithelioma-like gastric carcinoma.
Subject(s)
Humans , Male , Middle Aged , Carcinoma/diagnosis , Combined Modality Therapy , Lymphoma/diagnostic imaging , Pneumoperitoneum/etiology , Rupture, Spontaneous , Stomach Neoplasms/complications , Stomach Rupture/complications , Tomography, X-Ray ComputedABSTRACT
Gastric lymphoepithelioma-like carcinoma (LELC) is a rare neoplasm of the stomach that features undifferentiated carcinoma mixed with lymphoid stroma, and it invariably has a good prognosis. Most gastric LELCs have been linked to Epstein-Barr virus (EBV) infection. We experienced a case of a patient with gastric LELC. A 57 years old female patient was found to have shallow irregular ulcerative lesion on the gastric antrum. Although repetitive endoscopic biopsy didn't yield any cancer, early gastric cancer (EGC) was strongly suspected. Endoscopic submucosal dissection (ESD) was performed for establishing the correct diagnosis and curatively resecting the lesion. The pathology revealed gastric LELC with vertical invasion to the submucosa. No remnant cancer and no lymph node metastasis were noted after surgery following ESD. Here, we are reporting on a case of gastric ELEC along with reviewing the relevant literature. We believe this is the first case of gastric ELEC that was successfully diagnosed and managed by ESD.
Subject(s)
Female , Humans , Biopsy , Carcinoma , Herpesvirus 4, Human , Lymph Nodes , Neoplasm Metastasis , Prognosis , Pyloric Antrum , Stomach , Stomach Neoplasms , UlcerABSTRACT
Gastric lymphoepithelioma-like carcinoma (LELC) is a rare disease with a good prognosis. Submucosal LELC is very rare and difficult to diagnose by endoscopic biopsy. Endoscopic ultrasonography is the best modality for diagnosing submucosal tumors. Submucosal LELC can be confused with benign submucosal tumors. Here, we report a case of a submucosal gastric lymphoepithelioma-like carcinoma.
Subject(s)
Biopsy , Endosonography , Prognosis , Rare DiseasesABSTRACT
Lymphoepithelioma-like carcinoma (LELC) occurs in esophagus, stomach, bile duct, salivary gland, lung, uterus, skin, and so on. The incidence of gastric LELC is 1~4 percents of all stomach cancers. Gastric LELC has a lymphoid stroma and shows a good prognosis and high association with Epstein-Barr virus. We experienced a case of patient with gastric LELC. The patient was 49-year-old woman. and the endoscopic finding showed a submucosal tumor with central erosion. The histologic findings of endoscopic biopsies were suggestive of low grade MALT lymphoma. but the histologic findings of the surgical specimen were consistent with gastric LELC. We report a case of gastric LELC presenting as a submucosal tumor, with a brief review of the literature.