Epstein-Barr virus-associated thymic lymphoepithelial carcinoma in a child.
Marlene M Sepich, María L Herrera Andino, Alejandra A Cano et al.
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Case in brief
A 12-year-old patient presented with a mediastinal mass, supraclavicular lymphadenopathy, and pulmonary metastases. Histology established Epstein-Barr virus (EBV)-positive thymic lymphoepithelial carcinoma. The patient received cisplatin and gemcitabine chemotherapy, pembrolizumab immunotherapy, and radiotherapy, achieving complete remission.
What made this case unusual
The tumor’s clinical and imaging features overlap with lymphoma and mediastinal germ cell tumors, making diagnosis challenging; histology identified an EBV-positive thymic lymphoepithelial carcinoma in a child.
Diagnostic / clinical pearl
In a child with a mediastinal mass, lymphadenopathy, and pulmonary lesions, clinical and imaging findings may not distinguish thymic lymphoepithelial carcinoma from lymphoma or germ cell tumors; histological diagnosis is important.
Why it matters
Complete remission followed combined chemotherapy, pembrolizumab, and radiotherapy in this case. The report notes that anti-PD-1 immunotherapy may offer clinical benefit in EBV-positive tumors, while the outcome cannot establish treatment efficacy.