Malignant lymphoepithelial lesions of the salivary gland

OBJECTIVES: To describe a relatively large series of patients with uncommon malignant lymphoepithelial lesions (MLEL) in the salivary glands, to present treatment-outcome data to support therapeutic decision-making, and to evaluate the incidence of co-occurrence of MLEL and Epstein-Barr virus (EBV). STUDY DESIGN AND SETTING: Ten patients with MLEL were treated between 1987 and 2002. All lesions were surgically removed, with or without neck dissection, and the patients treated with radiotherapy or radiotherapy and chemotherapy. Histopathology and in situ hybridization studies for EBV-encoded RNA (EBER1) were performed. RESULTS: With aggressive treatment, outcomes were good, regardless of the presenting stage, except when distal metastases were present. All 10 patients tested positive for EBV. CONCLUSION AND SIGNIFICANCE: This and previous investigations support the use of aggressive surgical excision of the tumor and local metastases and radiotherapy or radiotherapy and chemotherapy, as optimal treatment for MLEL. The EBV finding may indicate a role for EBV in the pathogenesis of MLEL. EBM rating: C-4.