Letter To The Editor
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2020; 8(9): 1752-1755
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1752
Rare primary lymphoepithelioma-like carcinoma of the renal pelvis
Shi-Cong Lai, Samuel Seery, Tong-Xiang Diao, Jian-Ye Wang, Ming Liu
Shi-Cong Lai, Tong-Xiang Diao, Jian-Ye Wang, Ming Liu, Department of Urology, Beijing Hospital, Beijing 100730, China
Shi-Cong Lai, Tong-Xiang Diao, Jian-Ye Wang, Ming Liu, National Center of Gerontology, Beijing 100730, China
Shi-Cong Lai, Tong-Xiang Diao, Jian-Ye Wang, Ming Liu, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
Shi-Cong Lai, Jian-Ye Wang, Ming Liu, Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China
Samuel Seery, School of Humanities and Social Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Tong-Xiang Diao, Peking University Fifth School of Clinical Medicine, Beijing 100730, China
Author contributions: Lai SC and Liu M designed the study; Lai SC and Diao TX participated in collecting and interpreting the data; Lai SC and Seery S drafted and revised the paper; Liu M and Wang JY participated in critical reviewing the paper; all authors read and approved the final manuscript.
Supported by the Capital Clinical Characteristics Applications Research Program, No. Z171100001017201; and the Beijing Hospital Clinical Research 121 Project, No. BJ-2018-090.
Conflict-of-interest statement: The authors declare that they have no competing interests.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ming Liu, MD, Chief Doctor, Professor, Surgeon, Department of Urology, Beijing Hospital, No. 1 Dahua Road, Dongdan, Dongcheng District, Beijing 100730, China. liumingbjh@126.com
Received: February 28, 2020
Peer-review started: February 28, 2020
First decision: April 7, 2020
Revised: April 9, 2020
Accepted: April 24, 2020
Article in press: April 24, 2020
Published online: May 6, 2020
Processing time: 61 Days and 22.4 Hours
Abstract

Lymphoepithelioma-like carcinoma (LELC) is a rare, malignant epithelial tumour which can arise within the upper urinary tract. This letter adds to a previous systematic review and cumulative analysis of 28 published upper urinary tract-LELC cases which provided insight into this disease; however, the current evidence does not provide clinicians with clear guidelines due to its rarity. Therefore, the aim was to report a new case of renal pelvis LELC presented in our hospital. In this instance, we were able to report treatment experience and long-term follow-up results. This patient presented with hypertension and haemturia which initiated further investigation. While ultrasound identified an hypechoic mass, no malignant cells were detected using cytological testing. Abdominal magnetic resonance imaging identified a slightly enhanced mass in the left renal pelvis with no evidence of lymph node metastasis. Ureteroscopic tumor biopsy suggested the existence of urothelial carcinoma, hence, laparoscopic radical left nephroureterectomy with bladder cuff excision was performed. Through patient-practitioner consultations, we decided to adopt a "watch and wait" approach after radical nephroureterectomy rather than administering chemotherapy. Although, we would encourage clinicians to record and publish cases to garner insight into this type of malignant disease.

Keywords: Lymphoepithelioma-like carcinoma; Prognosis; Radical nephroureterectomy; Upper urinary tract; Treatment; Case report

Core tip: Lymphoepithelioma-like carcinoma arising within the upper urinary tract are extremely rare, and currently only 28 cases have been published. However, the current evidence is insufficient to provide clinicians with clear guidelines due to its rarity. Sharing new case reports of renal pelvis lymphoepithelioma-like carcinoma and treatment experiences is necessary. Our treatment experience and long-term follow-up results adds to this small but growing evidence base which suggests that favorable prognosis can be achieved with radical nephroureterectomy based therapy, even for some with later stage tumors.