A case of pulmonary lymphoepithelioma-like carcinoma with postoperative recurrence and rapid progression

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A 59-year-old man was referred to our hospital due to an abnormal chest shadow in the left lung field detected on a medical examination. A computed-tomography scan of the chest revealed a round mass of 13 mm in diameter in the left S<SUP>4</SUP>. Bronchial brushing cytology showed class II cells. On positron emission tomography, the tumor showed the accumulation of fluorodeoxyglucose. Lung cancer was suspected from these examinations, so wedge resection of the left upper lobe was performed. On intraoperative consultation, we could not come to a definitive diagnosis. Immunostaining revealed lymphoepithelioma-like carcinoma (LELC). We recommended left upper lobectomy and lymph node dissection to the patient, but he did not consent to another operation. Eight months after surgery, a tumor of the left hilum and mediastinal and left subclavian lymph node swelling was recognized. We performed 1 course of CDDP/VNR combined chemotherapy and 2 courses of CBDCA/PTX chemotherapy with concurrent radiotherapy. However, the tumor progressed and he died 13 months after surgery.LELC of the lung is a rare tumor in Japan. A review of the literature showed that LELC has a good prognosis, but we should treat LELC as carefully as common lung cancer.