A case of lymphoepithelioma-like carcinoma in the liver diagnosed via laparoscopic liver tumor resection

A 73-year-old female patient who achieved a sustained virological response for chronic hepatitis C 7 years ago presented with a single tumor in segment 7 of the liver upon screening with abdominal computed tomography. After percutaneous liver tumor biopsy, she was clinically diagnosed with poorly differentiated hepatocellular carcinoma. Following laparoscopic liver tumor resection, she was diagnosed with lymphoepithelioma-like carcinoma (LELC). Histopathological findings showed atypical cells with nuclear enlargement like hepatocytes and inflammatory cells including lymphocytes, whereas immunostaining showed that these atypical cells express epithelial markers. The patient has achieved relapse-free survival for more than 2 years since the operation. The diagnosis of LELC mainly depends on pathological findings, but it is often difficult to diagnose via liver biopsy because of its similarities to hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Thus, it is important to rule out LELC in cases of poorly differentiated carcinoma.