Lymphoepithelioma-like Carcinoma of the Skin: A Case with Perineural Invasion

SUMMARY: Lymphoepithelioma-like carcinoma of the skin is a rare, low malignant cutaneous neoplasm. We report a case of an elderly woman with lymphoepithelioma-like carcinoma of the skin in the forehead. The tumor was mistaken first as actinic keratosis and later as metastatic squamous cell carcinoma. A histological reassessment showed lymphoepithelioma-like carcinoma of the skin with perineural invasion, which is rare and considered more aggressive. The patient therefore received adjuvant radiotherapy after the recommended wide excision. Lymphoepithelioma-like carcinoma of the skin is a variant of squamous cell carcinoma, and histologically, it resembles the more aggressive lymphoepithelioma of the nasopharynx. The later is Epstein-Barr positive, whereas lymphoepithelioma-like carcinoma normally is not. Lymphoepithelioma-like carcinoma is an important diagnosis to know and the disease is discussed.