2022-RA-582-ESGO Lymphoepithelioma-like carcinoma of the uterine cervix: A-three case study

• Published in: International journal of gynecological cancer Vol. 32; no. Suppl 2; p. A14
• Main Authors: Bouguerra, Fadoua, Zanzouri, Rym, Attia, Najla, Melliti, Rihab, Sabrine, Tbessi, Bouzid, Nadia, Belajouza, Semia Kanoun, Tebra, Sameh
• Format: Journal Article
• Language: English
• Published: Oxford BMJ Publishing Group Ltd 20.10.2022; BMJ Publishing Group LTD
• Subjects: Cancer; Cervical cancer; Cervix; Patients; Radiation therapy
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-2022-ESGO.31

Introduction/BackgroundLymphoepithelioma-like carcinoma (LELC) is a rare variant of squamous cell carcinoma (0.7% of primary cervical tumors). It has been identified in the lung, thymus, stomach, salivary glands and skin. Uterine cervical localization is very rare.MethodologyA retrospective descriptive study of 3 patients diagnosed with LELC of the uterine cervix in the radiotherapy oncology department of Farhat Hachad Sousse. Data of the three cases was gathered between 1995 and 2018.ResultsThe patients were 26, 63 and 74 years old at the time of diagnosis. Clinical symptoms were dominated by metrorrhagia and pelvic pain. The gynecological examination showed a bleeding ulcerating mass of 4 to 12 cm long axis, delivered through the cervix in one patient and a bleeding cauliflower-like indurated cervix in the other two. The biopsy concluded to a LELC of the uterine cervix. The MRI showed locally advanced tumor with invasion of the vagina, parametria and posterior bladder wall, classified as IVA according to FIGO in all 3 patients. Node involvement of the internal iliacs was observed in one patient. Two patients had concomitant radio-chemotherapy and one patient was treated by exclusive Radiotherapy (RT). In the 3 patients, RT was delivered at a dose of 45Gy with a complement up to 66Gy in only 2 patients, at a rate of 1.8Gy/session, 5 sessions/week. The evolution was marked by the occurrence of two local recurrences after 4 to 5 years, treated by palliative CT. After a median follow-up time of 8 years, two patients died while one patient was in full recovery.ConclusionLELC of the uterine cervix is a very rare tumor, distinguished by its morphological character and its often favorable prognosis, which was not the case in our observation given the discovery of the tumor at a late stage compared to the literature.