Lymphoepithelioma of the Oropharynx

Abstract

Lymphoepithelioma is common in the nasopharynx, but its presence elsewhere in Waldeyer's ring is rare. Thirteen patients with lymphoepithelioma in the tonsil and base of the tongue have been treated at our institution. At Initial examination, all 13 patients had advanced clinical disease. Five years after their initial treatment, seven patients were alive and free of disease. Radiation therapy controlled local and regional disease in 10 (77%) patients, yet three of these died of distant metastasis. Patients with lymphoepithelioma have a significantly better prognosis (p < 0.05) than do patients with either nonkerafinizing or keratinizing high-grade oropharyngeal carcinoma. Early recognition and combined therapy may further improve the prognosis. Differentiation of lymphoepithelioma from other high-grade squamous cell carcinomas of the oropharynx is important to guide treatment and to provide prognostic information.

Get full access to this article

View all access options for this article.

References

Quayle

. Squamous cell carcinoma and lymphoepithelioma: A discussion based on a case report. Br Dent J 1975; 139: 101–4.

Martin

Sugarbaker

. Carcinoma of the tonsil. Am J Surg 1941; 52: 158–96.

Parkhill

. Tumors of the palatine tonsil. In: Dockerty

Parkhill

Dahlin

Woolner

Soule

Harrison

Jr , eds. Tumors of the oral cavity and pharynx. Atlas of tumor pathology, section IV, fascicle 10b. National Research Council, Committee on Pathology. Washington, DC: Armed Forces Institute of Pathology, 1968: 243–69.

Stanley

Weiland

DeSanto

Neel

III . Lymphoepithelioma (undifferentiated carcinoma) of the laryngohypopharynx. Laryngoscope 1985; 95: 1077–81.

Ferlito

. Primary lymphoepithelial carcinoma of the hypopharynx. J Laryngol Otol 1977; 91: 361–7.

Toker

Peterson

. Lymphoepithelioma of the vocal cord. Arch Otolaryngol 1978; 104: 161–2.

Shanmugaratnam

Sobin

. Histological typing of upper respiratory tract tumours (international histological typing of tumours; no 19). Geneva: World Health Organization, 1978.

Ewing

. Lymphoepithelioma. Am J Pathol 1929; 5: 99–107.

Regaud

Reverchon

. Sur un cas d'épithélioma épidermoïde développé dans le massif maxillaire supérieur, étendu aux téguments de la face, aux cavités buccale, nasale et obitaire, ainsi qu' aux ganglions du cou, quéri par la curiethèrapie. Rev Laryngol 1921; 42: 369–78.

10.

Schmincke

. Ueber lymphoepitheliale Geschwülste. Beitr Pathol Anat Allg Pathol 1921; 58: 161–70.

11.

Batsakis

Solomon

Rice

. The pathology of head and neck tumors: Carcinoma of the nasopharynx II. Head Neck Surg 1981; 3: 511–24.

12.

Hoppe

Williams

Warnke

Goffinet

Bagshaw

. Carcinoma of the nasopharynx—the significance of histology. Int J Radiat Oncol Biol Phys 1978; 4: 199–205.

13.

Dickson

. Nasopharyngeal carcinoma: An evaluation of 209 patients. Laryngoscope 1981; 91: 333–54.

14.

Applebaum

Mantravadi

Haas

. Lymphoepithelioma of the nasopharynx. Laryngoscope 1982; 92: 510–4.

15.

Scanlon

Rhodes

Jr Woolner

Devine

McBean

. Cancer of the nasopharynx: 142 patients treated in the 11 year period 1950–1960. Am J Roentgenol 1967; 99: 313–25.

16.

Bansberg

Olsen

Gaffey

. High-grade carcinoma of the oral cavity. Otolaryngol Head Neck Surg 1989; 100: 41–8.

17.

Neel

III Pearson

Weiland

Application of Epstein-Barr virus serology to the diagnosis and staging of North American patients with nasopharyngeal carcinoma. Otolaryngol Head Neck Surg 1983; 91: 255–62.