Lymphoepithelial carcinoma in the maxillary sinus: a case report

Abstract

IntroductionLymphoepithelial carcinoma of the maxillary sinus is a very rare malignancy and it can be difficult to make a pre-operative diagnosis.Case presentationA 72-year-old Caucasian woman presented to our facility with an isolated right-side epistaxis that had been present for three months, with the results of a computed tomography scan showing a soft tissue mass in the right maxillary sinus with an impacted tooth. The results of a transnasal endoscopic biopsy were compatible with a lymphoepithelial carcinoma, following which our patient underwent a radical excision of the mass. The final histology results revealed lymphoepithelial carcinoma of the maxillary sinus with negative assays for Epstein-Barr virus. Our patient was given post-operative external radiotherapy and has remained disease-free at three-year follow-up.ConclusionsThis report details the diagnosis and management of a case of lymphoepithelial carcinoma of the maxillary sinus, which is a very rare malignant tumor with very little mention in the literature. Only a strong suspicion with systematic use of various patho-immunological tests helps to arrive at a definitive diagnosis by excluding other better-known tumors.

A Rare Case of Sinonasal Lymphoepithelial Carcinoma Presented With Clinically Stage IV Disease

“…2 In our literature review, 3 of the 7 published cases with SLEC were negative for EBV. 6,8,11 Smoking, chewing tobacco, human papillomavirus, and alcoholism do not seem to be associated with LEC. 13…”

Lymphoepithelial carcinoma of the maxillary sinus

“…We found only 8 case reports of sinonasal LEC that included detailed patient information in the English literature from 1980 to 2016. [ 2 , 11 , 15 – 20 ] LEC originating from the maxillary sinus occurred in only 4 of the 8 cases. [ 2 , 11 , 15 , 16 ] The mean patient age in these 8 cases was 47.4 (range: 21–72) years; 5 of the patients were men and 3 were women.…”

“…[ 2 , 11 , 15 – 20 ] LEC originating from the maxillary sinus occurred in only 4 of the 8 cases. [ 2 , 11 , 15 , 16 ] The mean patient age in these 8 cases was 47.4 (range: 21–72) years; 5 of the patients were men and 3 were women. The clinical symptoms of the patients included epistaxis (n = 6; 75.0%), pain or headache (n = 4; 50.0%), nasal obstruction (n = 4; 50.0%), facial swelling (n = 3; 37.5%), and loss of taste and smell (n = 1; 12.5%).…”

“…Most cases of LEC occur in the nasopharynx and are pathologically classified as a nonkeratinizing undifferentiated type of nasopharyngeal carcinoma (NPC). [ 1 , 2 ] Although LEC is generally rare, when present, it tends to be located in various sites in the head and neck, [ 3 ] including the salivary glands, oral cavity, oropharynx, larynx, hypopharynx, lungs, and esophagus. [ 4 – 11 ] LEC involving the sinonasal tract is rare, especially in the maxillary sinus.…”

“…[ 4 – 11 ] LEC involving the sinonasal tract is rare, especially in the maxillary sinus. [ 1 , 2 ] Sinonasal LEC is more common in Southeast Asia, where the incidence of NPC is higher than that in Western countries. [ 1 , 12 ] Sinonasal LEC is extremely rare in other countries, including Japan, and its clinical characteristics remain unknown.…”