Epstein-Barr virus negative lymphoepithelial carcinoma of parotid gland - a case report with review of literature

Background: Primary lymphoepithelial carcinoma (LEC) of salivary gland is a rare tumor with strong racial and geographical predilection among Eskimos and Orientals in Greenland and Asia, and with strong association with Epstein-Barr virus (EBV). So far, only about 4 cases of EBV negative LEC of salivary gland were reported in the non-endemic area in non-predilected ethnic groups in the English literature. Case report: A 41 year old Hispanic female presented with right parotid mass. Fine needle aspiration of mass showed only lymphoid cells. Incisional biopsy showed anaplastic carcinoma cells with dense stromal lymphoplasmacytic infiltration, consistent with lymphoepithelial carcinoma. In-situ-hybridization (ISH) for EBV-encoded small RNAs (EBER) was negative. Discussion: The author reported a case of EBV negative LEC of salivary gland in a non-endemic area. The observation suggested that EBV may be an important contributing factor, but not a necessary factor in the pathogenesis of LEC of parotid gland. Other factors such as environmental and genetic predisposition may have a contributing role in the pathogenesis of the tumor. Additional studies in non-endemic areas will be necessary to clarify the pathogenesis.