Lymphoepithelioma-like carcinoma of the skin: new case of an exceedingly rare primary skin tumor.

Lymphoepithelioma-like carcinoma of the skin (LE-lCS) is a very rare, primary skin neoplasm of uncertain origin. The tumor reveals striking morphological similarity to undifferentiated nasopharyngeal carcinoma (lymphoepithelioma). However, the primary skin tumors have never been associated with Epstein-Barr virus (EBV), in contrast to those at some extracutaneous sites. Since the first description by Swanson et al. in 1988, only 46 cases have been documented over the last 20 years. This case report presents an 89-year-old woman with a 0.5 cm plaque-like, discolored lesion on her left cheek of one-month duration. The patient underwent surgical excision and is disease free one year later. The histopathological, immunohistochemical and EBV in situ hybridization features are described. The clinical and pathological differential diagnosis is discussed. This case supports the contention that LE-lCS is not associated with EBV.