Am J Otolaryngol Head Neck Surg | Volume 2, Issue 4 | Research Article | Open Access

Is Salivary Gland Lymphoepithelioma a Surgical Disease?

Najjar Esmat1*, Hilly O1, Salem B3, Feinmesser R1 and Popovtzer A2

1Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Israel
2Department of Oncology, Rabin Medical Center, Israel
3Division of Oncology, Rambam Health Care Campus, Israel

*Correspondance to: Najjar Esmat 

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Abstract

Background: Lymphoepithelioma-Like Carcinoma (LELC) is best known to occur in the nasopharynx, but can arise in other sites, such as the lung, thymus, stomach, and skin. Primary LELC of the salivary gland is rare, and is characterized by poor differentiation and high-grade histological appearance. There is unclarity regarding the optimal treatment of this rare disease. Based on the limited available data, surgery, radiation or a combination of them are accepted treatments for LELC. However the extent of surgery and radiation is controversial. Aim of Study: The aim of our study was to evaluate the clinicopathologic characteristics and disease outcome in patients with LELC of salivary glands.
Methods: Retrospective study.
Results: Five patients with LELC of a salivary gland were included. The tumor was located in the parotid in 4 patients and in the sublingual gland in 1 patient. Four were women, and the mean age at diagnosis was 60.4 years (range 19 years to 78 years). One had a history of tobacco abuse, and none used alcohol. Four patients underwent tumor resection and ipsilateral neck dissection, the other patient was treated only by radiotherapy. Two patients had positive surgical margins and 3 had involvement of regional lymph nodes. All patients underwent nasopharyngeal biopsy and a nasopharyngeal primary tumor was excluded. All patients received radiotherapy (66 Gy). Radiation field included the primary tumor site and ipsilateral neck, sparing the nasopharynx and the contralateral neck. PET-CT that was performed 3 months after the end of radiotherapy, demonstrated a complete response in all cases. During a mean follow-up period of 37 months (range 7 months to 72 months) none of the patients recurred.
Conclusion: Lymphoepithelioma-like carcinoma of the salivary gland is a rare entity, but despite its poor histological appearance, its clinical course is better than other poorly differentiated tumors. Our experience suggests that LELC of salivary glands is radiosensitive as a primary treatment, and good clinical results were also obtained in cases with positive surgical margins. LELC can be treated successfully with surgery and radiotherapy limited to the primary site and ipsilateral neck after exclusion of nasopharyngeal origin.

Keywords:

Lymphoepithelioma-like carcinoma; Salivary gland; Radiotherapy salivary gland

Citation:

Esmat N, Hilly O, Salem B, Feinmesser R, Popovtzer A. Is Salivary Gland Lymphoepithelioma a Surgical Disease? Am J Otolaryngol Head Neck Surg. 2019;2(4):1047.

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