[Lymphoepithelial carcinoma of the conjunctiva: an unusual location]

Lymphoepithelial carcinoma is an undifferentiated carcinoma associated with a lymphocytic infiltration and constitutes a rare category of malignant neoplasms that share morphologic features with undifferentiated nasopharyngeal carcinoma. Its pathogenic aspects remain unknown and it has been described at several sites, but it is rarely found in the conjunctiva. We report a case in a patient aged 66, revealed by a tumefaction of the internal angle of the left eye. The initial examination found a tumoral lesion in the medial canthus, extending to the medial half of the lower eyelid and a preauricular lymphadenopathy. Facial computed tomography scan showed that the lesion was responsible for an osteolysis of the medial wall of the left orbit. Histologic examination showed a proliferation of undifferentiated tumour cells with an intratumoral lymphocytic infiltrate. Immuno-histochemical evaluation led to a diagnosis of lymphoepithelial carcinoma (cytokeratin 7+, cytokeratin 20+, vimentin-). No Epstein-Barr viral genomic sequences were detected by in situ hybridization. Nasofibroscopy was normal. Treatment was a wide excision with enucleation, followed by 50 Gy external radiotherapy. After a follow-up period of 18 months, the patient was still in a situation of complete remission.