Journal of Prevention and Treatment for Stomatological Diseases ›› 2021, Vol. 29 ›› Issue (6): 400-405.doi: 10.12016/j.issn.2096-1456.2021.06.007

• Clinical Study • Previous Articles     Next Articles

Clinical analysis of 22 cases of lymphoepithelial carcinoma of parotid gland

ZHANG Shuguang1(),YIN Xiteng2,XU Wenguang2,HAN Wei2,LIU Zhe2()   

  1. 1. Department of Stomatology, Huaian Tumor Hospital, Huai’an 223001, China
    2. Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2021-01-05 Revised:2021-01-31 Online:2021-06-20 Published:2021-04-12
  • Contact: Zhe LIU E-mail:315725513@qq.com;kqliuzhe@163.com

Abstract:

Objective To investigate the diagnosis, treatment and prognosis of lymphoepithelial carcinoma of the parotid gland. Methods Data from 22 patients with parotid lymphoepithelial carcinoma from 2012 to 2019 were collected, and their clinical manifestations, imaging examinations, treatment methods and follow-up results were retrospectively analyzed. Results Among the 22 patients, 8 were males and 14 were females. The patients ranged from 26 to 61 years old, with a complaint duration ranging from 3 days to 18 years. One patient had multiple unilateral lumps in the parotid gland, and the other 21 patients had single unilateral lumps in the parotid gland. All patients underwent preoperative spiral CT examination. CT showed a soft tissue lump in the parotid tissue, the internal density shadow was not uniform, the CT value ranged from 26 to 81 Hu, and 15 patients presented elliptical lesions with clear boundaries. Seven patients presented nodular lesions, and the boundary was not clear. The diagnosis of all cases was ultimately based on pathological examination. Hematoxylin-eosin (HE) staining images showed active epithelial cell growth with atypia, mitotic figures could be seen, and abundant lymphocyte and plasma cell infiltration could be seen in the tumor stroma. All 22 patients received surgical treatment; 9 patients did not undergo cervical lymph node dissection. Twenty patients received adjuvant radiotherapy after surgery, and 10 of them received adjuvant chemotherapy at the same time. One patient only received chemotherapy after surgery, and one patient did not receive any other adjuvant therapy after surgery. All patients received follow-up visits. One patient died of liver metastasis 16 months after the operation, and the remaining patients survived without tumors for periods of 13 months to 8 years until the present. Conclusion Parotid lymphoepithelial carcinoma is a rare malignant tumor clinically. Pathology is still the gold standard for the diagnosis of lymphoepithelial carcinoma of the parotid gland. Radical resection of the tumor is the first choice of treatment. Selective neck lymph node dissection and postoperative adjuvant radiotherapy and chemotherapy can obtain better therapeutic effects according to clinical examination, imaging examination and neck conditions.

Key words: lymphoepithelial carcinoma, parotid gland, parotidectomy, facial nerve anatomy, neck lymphatic dissection, radiotherapy, chemotherapy

CLC Number: 

  • R78

Table 1

Clinical data of 22 patients with LEC in the parotid gland"

Serial number Gender Age Duration of disease according
to patients complaint
Stage Treatment Follow-up
1 Male 36 years 18 years cT1N0M0 S1 Tumor-free survival 8 years
2 Female 34 years 5 years pT1N0M0 S*+R+C Tumor-free survival 7 years
3 Female 48 years 7 months pT3N0M0 S#+R+C Tumor-free survival 7 years
4 Male 26 years 2 months pT1N0M0 S*+R+C Tumor-free survival 7 years
5 Female 56 years 2 years cT2N0M0 S1+R+C Tumor-free survival 6 years
6 Female 42 years 1 months cT2N0M0 S2+R+C Tumor-free survival 6 years
7 Female 48 years 2 years cT1N0M0 S1+R+C Tumor-free survival 6 years
8 Male 60 years 3 days cT2N0M0 S2+R Tumor-free survival 5 years
9 Female 28 years 1 week cT1N0M0 S1+R Tumor-free survival 5 years
10 Male 54 years 2 weeks cT3N0M0 S2+R Tumor-free survival 4 years
11 Female 49 years 4 years pT2N0M0 S*+R Tumor-free survival 35 months
12 Male 28 years 2 years pT2N0M0 S*+R Tumor-free survival 31 months
13 Female 61 years 10 days pT2N0M0 S*+R Tumor-free survival 29 months
14 Female 40 years 3 months cT2N0M0 S2+R+C Tumor-free survival 27 months
15 Male 32 years 10 months cT2N0M0 S1+C Tumor-free survival 16 months
16 Female 47 years 9 months pT2N0M0 S#+R+C Tumor-free survival 26 months
17 Female 41 years 1 year pT2N0M0 S#+R Tumor-free survival 25 months
18 Female 47 years 2 months pT1N0M0 S*+R+C Tumor-free survival 21 months
19 Female 55 years 7 months pT2N0M0 S#+R+C Tumor-free survival 19 months
20 Male 51 years 10 years pT2N0M0 S*+R Tumor-free survival 19 months
21 Male 42 years 3 months pT4aN0M0 S*+R Tumor-free survival 18 months
22 Female 45 years 2 weeks pT1N0M0 S*+R Tumor-free survival 13 months

Figure 1

CT axial image of lymphoepithelial carcinoma of the right parotid gland a: the soft tissue lump in the parotid gland tissue is elliptical, with clear boundaries; b: the soft tissue lump in the parotid gland tissue is nodular and the boundary is not clear"

Figure 2

Pathological manifestations of lymphoepithelial carcinoma a: HE staining images showed active epithelial cell growth with atypia, and mitotic figures (indicated by the arrow) can be seen (× 400); b: abundant lymphocyte cells infiltration can be seen in the tumor stroma (× 400); c: immunohistochemistry images showed epithelial tissue CK8/18 (+) (× 200); d: immunohistochemistry images showed epithelial tissue S-100 (+) (× 200); e: immunohistochemistry images showed interstitial lymphocytes CD3 (+) (× 200); f: immunohistochemistry images showed interstitial lymphocytes CD20 (+) (× 200)"

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