Huang FL, Luo M, He ZM, Shen YQ, Liu GD. Diagnosis and treatment of pulmonary lymphoepithelioma-like carcinoma: A case report. World J Clin Oncol 2025; 16(4): 104413 [DOI: 10.5306/wjco.v16.i4.104413]
Corresponding Author of This Article
Guan-Da Liu, MD, Department of Pharmacology and Clinical Pharmacy, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, No. 10 Huadong Road, Nanning 530000, Guangxi Zhuang Autonomous Region, China. rkjp2024@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Apr 24, 2025; 16(4): 104413 Published online Apr 24, 2025. doi: 10.5306/wjco.v16.i4.104413
Diagnosis and treatment of pulmonary lymphoepithelioma-like carcinoma: A case report
Feng-Ling Huang, Min Luo, Zhen-Mei He, Yong-Qi Shen, Guan-Da Liu
Feng-Ling Huang, Min Luo, Zhen-Mei He, Guan-Da Liu, Department of Pharmacology and Clinical Pharmacy, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530000, Guangxi Zhuang Autonomous Region, China
Yong-Qi Shen, Department of Oncology, The Third Affiliated Hospital of Guangxi College Traditional Chinese Medicine, Liuzhou 545007, Guangxi Zhuang Autonomous Region, China
Co-first authors: Feng-Ling Huang and Min Luo.
Co-corresponding authors: Yong-Qi Shen and Guan-Da Liu.
Author contributions: Shen YQ designed the research and obtained the funds for this research project; He ZM acquired and analyzed the clinical data, follow up with the patient and organize information; Shen YQ, Huang FL and Liu GD design the immunotherapy regimen and executed the research; Huang FL prepared the first draft of the manuscript; Luo M responsible for data re-analysis and re-interpretation, figure plotting, comprehensive literature search, preparation and submission of the current version of the manuscript; All authors have read and approved the final manuscript. both Huang FL and Luo M have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper. Both Liu GD and Shen YQ have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors.
Supported by Chinese Medicine Administration Bureau of Guangxi Zhuang Autonomous Region, No. GXZYB20220472.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guan-Da Liu, MD, Department of Pharmacology and Clinical Pharmacy, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, No. 10 Huadong Road, Nanning 530000, Guangxi Zhuang Autonomous Region, China. rkjp2024@163.com
Received: December 20, 2024 Revised: January 15, 2025 Accepted: February 25, 2025 Published online: April 24, 2025 Processing time: 97 Days and 2.4 Hours
Abstract
BACKGROUND
Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare primary epithelial lung cancer associated with the Epstein-Barr virus. Standard treatment guideline for PLELC is yet not to be established, surgery remains the primary treatment for early-stage PLELC, and platinum chemotherapy is the most common first-line treatment for advanced PLELC. While targeted therapy and immunotherapy has emerged as effective way to treat various malignant tumors, including lung cancer, reports on PLELC are relatively scarce.
CASE SUMMARY
A 38-year-old man was diagnosed with right PLELC. Chest computed tomography (CT) revealed a mass in the medial segment of the middle lobe of the right lung, with lymph node metastasis in the mediastinum and right hilum of the lung. CT-guided lung tumor biopsy was performed and the postoperative pathological examination combined with immune phenotype analysis and in situ hybridization confirmed PLELC. Standard molecular testing for patients with non-small cell lung cancer was negative and programmed cell death ligand-1 expression was about 2%. The patient declined radiotherapy and chemotherapy. Consequently, immunotherapy was administered, which included toripalimab 240 mg on day 1 and anlotinib 10 mg on days 1-14 for 10 cycles, followed by a maintenance dose of anlotinib 10 mg daily every 3 weeks. As a result, his progression-free survival reached 48 months.
CONCLUSION
A combination of toripalimab and anlotinib may benefit patients with advanced diseases who have not received systematic antitumor therapy.
Core Tip: We report a case of a 38-year-old man who was diagnosed with right pulmonary lymphoepithelioma-like carcinoma (PLELC). Chest computed tomography (CT) revealed a mass in the medial segment of the middle lobe of the right lung, with lymph node metastasis in the mediastinum and right hilum of the lung. CT-guided lung tumor biopsy was performed and the postoperative pathological examination combined with immune phenotype analysis and in situ hybridization confirmed PLELC. Standard molecular testing for patients with non-small cell lung cancer was negative and programmed cell death ligand-1 expression was about 2%. However, the patient declined radiotherapy and chemotherapy treatment. Consequently, immunotherapy was administered, which included toripalimab 240 mg on day 1 and anlotinib 10 mg on days 1-14 for 10 cycles, followed by a maintenance dose of anlotinib 10 mg daily every 3 weeks. As a result, his progression-free survival reached 48 months. PLELC is a rare primary epithelial lung cancer. Currently, there is no standard treatment for PLELC. A combination of toripalimab and anlotinib may benefit patients with advanced diseases who have not received systematic anti-tumor therapy. However, its long-term efficacy requires further comprehensive research and validation.
