Lymphoepithelial carcinoma of the esophagus with primary squamous cell carcinoma of the hypopharynx: complete response was achieved by chemoradiation therapy.

A 52-year-old male presented with a 3-month history of dysphagia. Laryngological examination showed a left-sided hypopharyngeal tumor, and biopsy of biopsy the tumor revealed moderately differentiated squamous cell carcinoma (SCC). Computed tomography (CT) and esophagogastroduodenoscopy also revealed a 50 mm mass in the middle thoracic esophagus. Biopsy of the esophageal tumor revealed lymphoepithelial carcinoma (LEC), characterized by lymphoplasmacytic infiltration and atypical immunohistochemical markers: The infiltrated cells were positive for EMA, partially positive for cytokeratin (CK) AE1/AE3, slightly positive for p63, and negative for CK5/6, synaptophysin, chromogranin A, CK7, p40, S100, HMB45, Melan A, and EBER-ISH. The patient underwent chemoradiotherapy (CRT) with 50.4 Gy in 24 fractions and concurrent chemotherapy with cisplatin and 5-fluorouracil. After CRT, both the tumors showed complete resolution on CT and endoscopy. No recurrence has been observed for 17 months. LEC, often associated with Epstein-Barr virus (EBV), is extremely rare in the esophagus. To our knowledge, this is the first reported case of coexistence of esophageal LEC and primary hypopharyngeal SCC, in which complete response was achieved by CRT.