Lymphoepithelioma-Like Carcinoma of the Urinary Bladder: A Case Report

Lymphoepithelioma-like carcinoma (LELC) of the bladder is a rare variant of urothelial carcinoma that histologically resembles lymphoepithelioma of the nasopharynx. Due to its rarity, prognostic outcomes and optimal treatment strategies remain unclear. We present the case of a 60-year-old male who presented with gross hematuria. Imaging revealed an anterior bladder wall mass. The patient underwent transurethral resection of a papillary lesion located at the bladder dome, with histopathological evaluation confirming LELC. He received neoadjuvant chemotherapy; however, follow-up cystoscopy revealed recurrence. A repeat endoscopic resection confirmed persistent disease, and the patient subsequently underwent partial cystectomy. Two follow-up cystoscopies showed no evidence of recurrence. Bladder LELC may present in pure, predominant, or focal forms, with prognosis influenced by the proportion of lymphoepithelial components. Immunohistochemistry is essential for diagnosis. Although Epstein-Barr virus has been associated with LELC in other sites, it has not been implicated in the bladder. Multimodal treatment, typically involving surgery and cisplatin-based chemotherapy, is commonly employed. In this case, partial cystectomy led to favorable short-term outcomes. Further research is needed to establish standardized treatment protocols.