Published online Aug 16, 2014. doi: 10.4253/wjge.v6.i8.385
Revised: April 8, 2014
Accepted: June 27, 2014
Published online: August 16, 2014
Processing time: 183 Days and 1.6 Hours
Esophageal lymphoepithelioma-like carcinoma (LELC) is extremely rare. We report the first case of esophageal LELC showing macroscopic reduction. A 67-year-old male presented with dysphagia and, by endoscopic examination, was found to have a significantly raised tumor of 10 mm in diameter in the thoracic esophagus. The biopsied material showed esophageal cancer. We performed endoscopic submucosal dissection. However, the tumor became flattened, similar to a scar, in only 2 mo. Histologically, the carcinoma cells had infiltrated the submucosal layer. Prominent infiltration of T lymphoid cells that stained positive for CD8 was observed around the carcinoma cells. Therefore, this lesion was considered to be an LELC with poorly differentiated squamous cells. Because the margin was positive, an esophagectomy was performed. Carcinoma cells were detected in the neck in one lymph node. The staging was T1N0M1b. However, the patient has been well, without adjuvant therapy or recurrence, for more than 5 years.
Core tip: The first case of esophageal lymphoepithelioma-like carcinoma showing macroscopic reduction is reported. In only 2 mo, the appearance of the esophageal tumor changed from a protruding lesion to a flat scar-like entity. After esophagectomy, one lymph node was diagnosed with metastasis. Prominent infiltration of T lymphoid cells that stained positive for CD8 was observed around the carcinoma cells. Strong expression of human leukocyte antigen-DR was evident in the cell membrane. The immune responses against the main tumor and the denatured carcinoma cells in the metastatic lymph node developed at the same time. Therefore, systemic immune responses against the carcinoma might have been occurring.