{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T15:45:40Z","timestamp":1777045540206,"version":"3.51.4"},"reference-count":72,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Thymic lymphoepithelial carcinoma (TLEC) is a primary thymic carcinoma that accounts for about 14% of all thymic epithelial tumors and is classified into 14 types. The histological morphology is similar to lymphoepithelioma, a type of undifferentiated nasopharyngeal carcinoma. It has been reported that squamous carcinoma accounts for approximately 80% of thymic carcinoma, followed by TLEC, which accounts for 6%. TLEC has been reported to be associated with Epstein-Barr virus (EBV), with EBV infection in TLEC tumor cells first noted by Lyvraz et al. in 1985. Tumors shown to be EBV-positive are classified as TLEC if lymphoplasmacytic infiltration is lacking. However, only about 50% of the cases are positive for EBV, which is lower compared to nasopharyngeal lymphoepithelioma. Instances of EBV infection in other types of thymic epithelial tumor have been reported at lower rates, which suggests that EBV infection may have an important influence on the carcinogenesis of TLEC, though the etiology is unknown. TLEC is a highly malignant tumor with poor prognosis, as affected patients have a median survival time of 22 months, according to 58 cases from the literature, while the 5-year survival rate is 34.4%. Presently, prognosis is not considered to be affected by the presence or absence of EBV positivity.<\/jats:p>","DOI":"10.3390\/cancers13194794","type":"journal-article","created":{"date-parts":[[2021,9,27]],"date-time":"2021-09-27T01:59:47Z","timestamp":1632707987000},"page":"4794","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Thymic Lymphoepithelial Carcinoma Associated with Epstein-Barr Virus: Experiences and Literature Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3509-9536","authenticated-orcid":false,"given":"Naoko","family":"Ose","sequence":"first","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachi","family":"Kawagishi","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka International Cancer Institute, Chuo-ku, Osaka-shi 541-8567, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soichiro","family":"Funaki","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Kanou","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3800-1327","authenticated-orcid":false,"given":"Eriko","family":"Fukui","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masato","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2540-5288","authenticated-orcid":false,"given":"Yasushi","family":"Shintani","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-shi 565-0871, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,24]]},"reference":[{"key":"ref_1","unstructured":"Travis, W.D., Brambillia, E.B., Burke, A.P., Marx, A., and Nicholson, A.G. (2015). WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart, IARC Press. [4th ed.]."},{"key":"ref_2","unstructured":"WHO Classification of Tumours Editorial Board (2021). Thoracic Tumours, International Agency for Research on Cancer. [5th ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1093\/ajcp\/103.3.308","article-title":"The Role of Epstein-Barr Virus in Lymphoepithelioma-like Carcinomas","volume":"103","author":"Iezzoni","year":"1995","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1288\/00005537-199103000-00010","article-title":"Detection of Epstein-Barr Virus DNA in Formalin-Fixed Paraffin-Embedded Tissue of Nasopharyngeal Carcinoma Using Polymerase Chain Reaction and In Situ Hybridization","volume":"101","author":"Akao","year":"1991","journal-title":"Laryngoscope"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s12105-011-0278-7","article-title":"Lymphoepithelial Carcinoma: Two Case Reports and a Systematic Review of Oral and Sinonasal Cases","volume":"5","author":"Hirvikoski","year":"2011","journal-title":"Head Neck Pathol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.jss.2014.12.005","article-title":"Lymphoepithelioma-like carcinoma: A distinct type of gastric cancer","volume":"194","author":"Park","year":"2015","journal-title":"J. Surg. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"18","DOI":"10.11604\/pamj.2019.32.18.15978","article-title":"Lymphoepithelioma-like carcinoma of the breast: A case report and review of the literature","volume":"32","author":"Fadila","year":"2019","journal-title":"Pan Afr. Med. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"98","DOI":"10.5114\/pjp.2018.75344","article-title":"Lymphoepithelioma-like breast carcinoma","volume":"69","author":"Koufopoulos","year":"2018","journal-title":"Pol. J. Pathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3108","DOI":"10.1038\/s41467-019-10902-w","article-title":"The genomic landscape of Epstein-Barr virus-associated pulmonary lymphoepithelioma-like carcinoma","volume":"10","author":"Hong","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.ajpath.2017.02.022","article-title":"Lymphoepithelioma-Like Carcinoma in Liver","volume":"187","author":"Labgaa","year":"2017","journal-title":"Am. J. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s13000-020-01035-6","article-title":"Lymphoepithelioma-like carcinoma in liver not associated with Epstein-Barr virus: A report of 3 cases and literature review","volume":"15","author":"Zhang","year":"2020","journal-title":"Diagn. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1590\/abd1806-4841.20187205","article-title":"Lymphoepithelioma-like carcinoma of the skin","volume":"93","author":"Oliveira","year":"2018","journal-title":"An. Bras. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Yoshino, T., Ohara, S., and Moriyama, H. (2014). Lymphoepithelioma-like carcinoma of the urinary bladder: A case report and review of the literature. BMC Res. Notes, 7.","DOI":"10.1186\/1756-0500-7-779"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Yordanov, A., Karamanliev, M., Karcheva, M., Konsoulova, A., Vasileva-Slaveva, M., and Strashilov, S. (2019). Single-Center Study of Lymphoepithelioma-Like Carcinoma of Uterine Cervix over a 10-Year Period. Medicina, 55.","DOI":"10.3390\/medicina55120780"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1097\/JTO.0000000000000269","article-title":"Development of the International Thymic Malignancy Interest Group International Database: An Unprecedented Resource for the Study of a Rare Group of Tumors","volume":"9","author":"Huang","year":"2014","journal-title":"J. Thorac. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1093\/ejcts\/ezv239","article-title":"Long-term outcome and prognostic factors of surgically treated thymic carcinoma: Results of 306 cases from a Japanese Nationwide Database Study","volume":"49","author":"Hishida","year":"2016","journal-title":"Eur. J. Cardio Thorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s40792-019-0706-6","article-title":"Total thymectomy for thymic lymphoepithelioma-like carcinoma\u2014Report of two cases","volume":"5","author":"Kawagishi","year":"2019","journal-title":"Surg. Case Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1440-1843.2006.00910.x","article-title":"Lymphoepithelioma-like carcinoma of the lung","volume":"11","author":"Ho","year":"2006","journal-title":"Respirology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1046\/j.1365-2559.2002.01328.x","article-title":"Immunohistochemical markers in the differentiation of thymic and pulmonary neoplasms","volume":"40","author":"Pomplun","year":"2002","journal-title":"Histopathology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/BF01612643","article-title":"Thymic carcinoma. Report of five cases and review of the literature","volume":"116","author":"Hartmann","year":"1990","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_21","first-page":"385","article-title":"Epstein-Barr virus genome in thymoma and thymic lymphoid hyperplasia","volume":"131","author":"McGuire","year":"1988","journal-title":"Am. J. Pathol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1097\/00007611-198805000-00031","article-title":"Thymic carcinoma: Clinical findings in two patients with extrathoracic metastases","volume":"81","author":"Taylor","year":"1988","journal-title":"South. Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1080\/14017439850140256","article-title":"Thymic Lymphoepithelioma-like Carcinoma Associated with Thymoma in a Patient with Ocular Myasthenia","volume":"32","author":"Hsu","year":"1998","journal-title":"Scand. Cardiovasc. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1097\/MPH.0b013e31802d3a83","article-title":"Thymic Lymphoepitheliomalike Carcinoma in Children: Clinicopathologic Features and Molecular Analysis","volume":"28","author":"Hsueh","year":"2006","journal-title":"J. Pediatr. Hematol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1002\/mpo.2950230214","article-title":"Hypertrophic pulmonary osteoarthropathy in a child with thymic carcinoma: An Unusual presentation in childhood","volume":"23","author":"Ilhan","year":"1994","journal-title":"Med. Pediatr. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1080\/08880010050211420","article-title":"Thymic Carcinoma, Systemic Lupus Erythematosus, And Hypertrophic Pulmonary Osteoarthropathy in an 11-Year-Old Boy: A Novel Association","volume":"17","author":"Villari","year":"2000","journal-title":"Pediatr. Hematol. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1002\/(SICI)1096-911X(199606)26:6<419::AID-MPO10>3.0.CO;2-6","article-title":"Treatment of pediatric malignant thymoma: Long-term remission in a 14-year-old boy with EBV-associated thymic carcinoma by aggressive, combined modality treatment","volume":"26","author":"Niehues","year":"1996","journal-title":"Med. Pediatr. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1007\/s00467-007-0666-0","article-title":"Lymphoepithelioma-like thymic carcinoma in a 16-year-old boy with nephrotic syndrome\u2014A case report","volume":"23","author":"Dobaczewski","year":"2008","journal-title":"Pediatr. Nephrol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1097\/RLU.0b013e3181b53f5a","article-title":"Epstein-Barr Virus (EBV) Associated Lymphoepithelioma-Like Thymic Carcinoma Associated with Paraneoplastic Syndrome of Polymyositis: A rare tumor with rare association","volume":"34","author":"Koppula","year":"2009","journal-title":"Clin. Nucl. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"715","DOI":"10.3892\/mco.2016.803","article-title":"Response to chemotherapy with carboplatin plus albumin-bound paclitaxel in a patient with lymphoepithelioma-like thymic carcinoma: A case report","volume":"4","author":"Shima","year":"2016","journal-title":"Mol. Clin. Oncol."},{"key":"ref_31","first-page":"113","article-title":"A case of anterior mediastinal lymphoepithelioma-like carcinoma successfully treated with radiation monotherapy","volume":"8","author":"Fujita","year":"2019","journal-title":"Jpn. J. Chest Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.ejrad.2006.05.003","article-title":"Thymic epithelial tumors: Comparison of CT and MR imaging findings of low-risk thymomas, high-risk thymomas, and thymic carcinomas","volume":"60","author":"Sadohara","year":"2006","journal-title":"Eur. J. Radiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S1040-8428(02)00112-9","article-title":"Immunological aspects of Epstein\u2013Barr virus infection","volume":"44","author":"Ohga","year":"2002","journal-title":"Crit. Rev. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.semcancer.2014.01.003","article-title":"Epigenetic regulation of EBV persistence and oncogenesis","volume":"26","author":"Tempera","year":"2014","journal-title":"Semin. Cancer Biol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.3892\/ol.2014.2475","article-title":"Clinical outcome of thymic lymphoepithelioma-like carcinoma: Case report of a 14-year-old male","volume":"8","author":"Sekihara","year":"2014","journal-title":"Oncol. Lett."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1080\/08880010701440882","article-title":"The Coexistence of Thymic Carcinoma And Multiple Granulomas In A Turkish Child","volume":"24","author":"Yavuz","year":"2007","journal-title":"Pediatr. Hematol. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"8227","DOI":"10.1128\/JVI.01089-13","article-title":"Epstein-Barr Virus Latent Membrane Protein 2A Contributes to Anoikis Resistance through ERK Activation","volume":"87","author":"Iwakiri","year":"2013","journal-title":"J. Virol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1056\/NEJMoa011610","article-title":"Serologic Markers of Epstein\u2013Barr Virus Infection and Nasopharyngeal Carcinoma in Taiwanese Men","volume":"345","author":"Chien","year":"2001","journal-title":"N. Engl. J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"6742","DOI":"10.1093\/emboj\/19.24.6742","article-title":"Epstein\u2013Barr virus-encoded poly(A)\u2013 RNA supports Burkitt\u2019s lymphoma growth through interleukin-10 induction","volume":"19","author":"Kitagawa","year":"2000","journal-title":"EMBO J."},{"key":"ref_40","first-page":"7062","article-title":"Autocrine growth of Epstein-Barr virus-positive gastric carcinoma cells mediated by an Epstein-Barr virus-encoded small RNA","volume":"63","author":"Iwakiri","year":"2003","journal-title":"Cancer Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1038\/sj.onc.1208357","article-title":"Epstein\u2013Barr virus-encoded small RNA induces insulin-like growth factor 1 and supports growth of nasopharyngeal carcinoma-derived cell lines","volume":"24","author":"Iwakiri","year":"2004","journal-title":"Oncogene"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5332","DOI":"10.1158\/0008-5472.CAN-04-0733","article-title":"Epstein-Barr Virus (EBV)-Encoded RNA Promotes Growth of EBV-Infected T Cells through Interleukin-9 Induction","volume":"64","author":"Yang","year":"2004","journal-title":"Cancer Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1097\/00000478-198908000-00001","article-title":"Analysis of Lymphoepithelioma and Lymphoepithelioma-like Carcinomas for Epstein-Barr Viral Genomes by in situ Hybridization","volume":"13","author":"Weiss","year":"1989","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_44","first-page":"107","article-title":"EBER-1 expression in thymic carcinoma","volume":"43","author":"Fujii","year":"1993","journal-title":"Pathol. Int."},{"key":"ref_45","first-page":"653","article-title":"Thymic neoplasia in two male siblings","volume":"57","author":"Wick","year":"1982","journal-title":"Mayo Clin. Proc."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1056\/NEJM198505163122006","article-title":"Association of Epstein\u2013Barr Virus with Thymic Carcinoma","volume":"312","author":"Leyvraz","year":"1985","journal-title":"N. Engl. J. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2475","DOI":"10.1002\/1097-0142(19880615)61:12<2475::AID-CNCR2820611215>3.0.CO;2-5","article-title":"Association of the epstein-barr virus with lymphoepithelioma of the thymus","volume":"61","author":"Dimery","year":"1988","journal-title":"Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1002\/ana.21902","article-title":"Epstein-barr virus persistence and reactivation in myasthenia gravis thymus","volume":"67","author":"Cavalcante","year":"2009","journal-title":"Ann. Neurol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1080\/08916930802024772","article-title":"Regulation and dysregulation of Epstein\u2013Barr virus latency: Implications for the development of autoimmune diseases","volume":"41","author":"Niller","year":"2008","journal-title":"Autoimmunity"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13027-019-0254-5","article-title":"Association between Epstein-Barr virus and Thymic epithelial tumors: A systematic review","volume":"14","author":"Zhang","year":"2019","journal-title":"Infect. Agents Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1309\/AJCP88FZTWANLRCB","article-title":"Thymic Carcinoma, Part 1: A Clinicopathologic and Immunohistochemical Study of 65 Cases","volume":"138","author":"Weissferdt","year":"2012","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1097\/PAS.0000000000001101","article-title":"Poorly Differentiated Nonkeratinizing Squamous Cell Carcinoma of the Thymus: Clinicopathologic and Molecular Genetic Study of 25 Cases","volume":"42","author":"Suster","year":"2018","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_53","first-page":"1896","article-title":"Clinicopathologic features and treatment of thymic lymphoepithelioma-like carcinoma: Two case reports and literature review","volume":"13","author":"Guan","year":"2021","journal-title":"Am. J. Transl. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/path.1711650105","article-title":"Epstein-Barr virus and carcinomas: Undifferentiated carcinomas but not squamous cell carcinomas of the nasopharynx are regularly associated with the virus","volume":"165","author":"Niedobitek","year":"1991","journal-title":"J. Pathol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/00000478-199001000-00003","article-title":"Thymic carcinomas: Histopathological varieties and immunohistochemical study","volume":"14","author":"Kuo","year":"1990","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1349-7006.1992.tb00075.x","article-title":"Detection of Epstein-Barr Virus DNA in a Japanese Case of Lymphoepithelioma-like Thymic Carcinoma","volume":"83","author":"Matsuno","year":"1992","journal-title":"Jpn. J. Cancer Res."},{"key":"ref_57","first-page":"363","article-title":"In situ localization of Epstein-Barr virus in thymic carcinoma","volume":"5","author":"Mann","year":"1992","journal-title":"Mod. Pathol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1093\/infdis\/170.1.7","article-title":"Thymic Carcinoma with a Defective Epstein-Barr Virus Encoding the BZLFI trans-Activator","volume":"170","author":"Patton","year":"1994","journal-title":"J. Infect. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/0046-8177(93)90031-B","article-title":"Study of Epstein-Barr virus early RNA1 (EBER1) expression by in situ hybridization in thymic epithelial tumors of Chinese patients in Taiwan","volume":"24","author":"Wu","year":"1993","journal-title":"Hum. Pathol."},{"key":"ref_60","first-page":"494","article-title":"Thymic carcinoma. Outcome of treatment including surgical resection","volume":"48","author":"Takahashi","year":"2000","journal-title":"Gen. Thorac. Cardiovasc. Surg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1097\/00043426-200003000-00016","article-title":"Epstein-Barr Virus-Positive Undifferentiated Thymic Carcinoma in a 12-Year-Old White Girl","volume":"22","author":"Galambrun","year":"2000","journal-title":"J. Pediatr. Hematol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S0090-3019(01)00361-5","article-title":"Multiple brain metastases from \u201clymphoepithelioma-like\u201d thymic carcinoma: A combined stereotactic-radiosurgical approach","volume":"55","author":"Nicolato","year":"2001","journal-title":"Surg. Neurol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1046\/j.1365-2559.2001.01133.x","article-title":"The spectrum of micronodular thymic epithelial tumours with lymphoid B-cell hyperplasia","volume":"38","author":"Tateyama","year":"2001","journal-title":"Histopathology"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1002\/pbc.20468","article-title":"Thymic carcinoma in children","volume":"47","author":"Yaris","year":"2006","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1016\/j.ijid.2012.05.203","article-title":"Is lymphoepithelioma like carcinoma of thymic caused by ebv infection?","volume":"16","author":"Januszkiewicz","year":"2012","journal-title":"Int. J. Infect. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"52","DOI":"10.12968\/hmed.2019.80.1.52","article-title":"Nephrotic syndrome: First presentation of lymphoepithelioma-like thymic carcinoma","volume":"80","author":"Pan","year":"2019","journal-title":"Br. J. Hosp. Med."},{"key":"ref_67","first-page":"339","article-title":"Nasopharyngeal Carcinoma: An Evolving Role for the Epstein\u2013Barr Virus","volume":"390","year":"2015","journal-title":"Curr. Top. Microbiol. Immunol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jtcvs.2014.09.124","article-title":"Thymic carcinoma outcomes and prognosis: Results of an international analysis","volume":"149","author":"Ahmad","year":"2015","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1097\/JTO.0000000000000128","article-title":"Thymic Carcinoma: A Cohort Study of Patients from the European Society of Thoracic Surgeons Database","volume":"9","author":"Ruffini","year":"2014","journal-title":"J. Thorac. Oncol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1093\/annonc\/mdu541","article-title":"A multicenter phase II study of carboplatin and paclitaxel for advanced thymic carcinoma: WJOG4207L","volume":"26","author":"Hirai","year":"2015","journal-title":"Ann. Oncol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"153043","DOI":"10.1016\/j.prp.2020.153043","article-title":"Primary pulmonary lymphoepithelioma-like carcinoma is characterized by high PD-L1 expression, but low tumor mutation burden","volume":"216","author":"Wu","year":"2020","journal-title":"Pathol. Res. Pract."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1200\/JCO.2017.77.3184","article-title":"Pembrolizumab for Patients With Refractory or Relapsed Thymic Epithelial Tumor: An Open-Label Phase II Trial","volume":"37","author":"Cho","year":"2019","journal-title":"J. Clin. Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/19\/4794\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:04:46Z","timestamp":1760166286000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/19\/4794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,24]]},"references-count":72,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["cancers13194794"],"URL":"https:\/\/doi.org\/10.3390\/cancers13194794","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,24]]}}}