Lymphoepithelioma-like Hepatocellular Carcinoma: a Case Report and Review of Literature

We report a case of hepatic lymphoepithelioma-like carcinoma-hepatocellular carcinoma subtype (LEL-HCC) in a 41-year-old man with chronic hepatitis C virus (HCV) infection. The patient presented with abdominal pain and further assessment revealed a hypoechoic mass on ultrasonography. Serum alpha-fet...

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Bibliographic Details
Published in:Journal of gastrointestinal cancer 2023-03, Vol.54 (1), p.275-281
Main Authors: Sweed, Dina, Sultan, Mervat M., Mosbeh, Asmaa, Fayed, Yahya A., Abdelsameea, Eman, Ehsan, Nermine A., Abdel-Rahman, Mohamed H., Waked, Imam
Format: Article
Language:English
Subjects:
Adult
alpha-Fetoproteins
Cancer Research
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Case Report
Gastroenterology
Hepatitis C, Chronic - complications
Humans
Internal Medicine
Liver Neoplasms - diagnosis
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Oncology
Radiotherapy
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Summary:We report a case of hepatic lymphoepithelioma-like carcinoma-hepatocellular carcinoma subtype (LEL-HCC) in a 41-year-old man with chronic hepatitis C virus (HCV) infection. The patient presented with abdominal pain and further assessment revealed a hypoechoic mass on ultrasonography. Serum alpha-fetoprotein (AFP) was 13·6 ng/dl. The patient was diagnosed as hepatocellular carcinoma based on the established triphasic computed tomography (TCT) diagnostic criteria and he underwent a surgical resection of the mass. Microscopic examination showed sheets and cords of malignant epithelial cells intermixed with heavy lymphoid infiltrate, with more than 100 tumor-infiltrating lymphocytes (TILs) per 10 high-power-field (HPF). Based on immunohistochemical studies, the malignant cells were positive for Hep Par 1 and glypican 3, focally positive for cytokeratin 7 (CK7), and negative for cytokeratin 20 (CK20). TILs were diffusely positive for cluster of differentiation 3 CD3 with an approximately equal CD4/CD8 ratio. The patient was recurrence free at 25 months after surgery, as evident by CT and serum alpha-fetoprotein level. LEL-HCC is a rare variant of HCC with a relatively better prognosis. Exploring the potential for immune modulator-based therapy in this subset of tumors is highly recommended.
ISSN:1941-6628
1941-6636
DOI:10.1007/s12029-021-00757-0