Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1752
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
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.
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.