Testicular Metastasis of Merkel’s Cell Carcinoma

Merkel cell carcinoma (MCC) in an uncommon neuroendocrine neoplasia that originates in the skin in which testicular metastasis is atypical. There are only eight cases reported to date. A 65-year-old patient with a history of MCC in the right thigh who had been treated in 2015 with surgery, chemotherapy and radiation therapy; presented to hospital with pain and right testicular enlargement of one-month duration and with normal testicular tumor markers. An ultrasound study confirmed multiple hypoechoic nodular solid lesions compatible with neoplasia and orchiectomy was subsequently performed. The histological examination reported an immunohistochemical pattern compatible with a diagnosis of MCC. The patient received adjuvant immunotherapy with Avelumab. MCC rarely spreads to the testicle and, due to the shortage of studies, the best treatment of testicular metastasis remains uncertain; however, immunotherapy may be appropriate.

Download Full-text

Epileptic Seizure Provoked by Bone Metastasis of Chronic Lymphoid Leukemia and Merkel Cell Carcinoma – Case Report

10.21203/rs.2.358/v1 ◽

2019 ◽

Author(s):

András Folyovich ◽

Angéla Majoros ◽

Tamás Jarecsny ◽

Gitta Pánczél ◽

Zsuzsanna Pápai ◽

...

Keyword(s):

Bone Metastases ◽

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Cerebral Metastasis ◽

Merkel Cell ◽

Lymphoid Leukemia ◽

Chronic Lymphoid Leukemia ◽

History Of ◽

The Right ◽

The Brain

Abstract Background Merkel cell carcinoma (MCC) is a rare primary neuroendocrine cutaneous tumor, rarely metastatizing to the brain. Chronic lymphoid leukemia (CLL) is a disease predisposing to MCC. According to previous reports, headache and focal neurological deficits suggest disease progression to the brain. We present a patient with MCC whose seizure was not elicited by a cerebral metastasis, but by bone metastases compressing the brain. Case presentation The 62-year-old female patient had a history of CLL. A lesion with the appearance of an atheroma was removed from the right upper arm. Histology confirmed the diagnosis of MCC. She was admitted to the neurology department with her first GM seizure. The cranial MRI/MRA showed bone metastases in the right parietal and left frontal areas, compressing the brain. Flow cytometry of CSF did not reveal metastasis of MCC or CLL. No surgery was performed, chemotherapy was continued. Conclusions The case history of the patient was unique even among the rare cases of MCC with neurological involvement. The seizure was not elicited by a cerebral metastasis, but by bone metastases compressing the brain. In addition to patient history, clinical presentation and radiological findings enabled a suspected diagnosis preceding confirmation by laboratory methods.

Download Full-text

Angiosarcoma in Collision With a Merkel Cell Carcinoma: Case Report and Literature Review

International Journal of Surgical Pathology ◽

10.1177/1066896919880260 ◽

2019 ◽

Vol 28 (3) ◽

pp. 325-329

Author(s):

Sean Hacking ◽

Hector Chavaria ◽

Leonard Khan ◽

Kasturi Das

Keyword(s):

Radiation Therapy ◽

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Collision Tumor ◽

Molecular Profile ◽

Rare Entity ◽

Merkel Cell ◽

Elderly Males ◽

History Of ◽

Rare Malignancy

Merkel cell carcinoma (MCC) is a rare entity that most commonly arises from the skin. Angiosarcoma (AS) is a rare malignancy with a predilection for elderly males, has endothelial differentiation and a notoriously poor prognosis despite aggressive therapy. Herein, we report an angiosarcoma colliding with a MCC, in a patient with a past medical history of squamous cell carcinoma, status-post radiation therapy. More specifically, our case represents a collision tumor, a rare entity composed of two histologically distinct neoplasms which coincide together at the same location. This case represents the first documented report of such a presentation. With that being said, its clinical course, prognosis, pathogenesis, and molecular profile, currently remains unclear. Importantly, neoplasms are increasingly being found to be associated with radiation therapy, of which our patient had received. Ultimately, however, with the lack of c-MYC immunohistochemical staining, and a short duration between radiation exposure and presentation, the AS in our case was likely coincidental.

Download Full-text

Epileptic Seizure Provoked by Bone Metastasis of Chronic Lymphoid Leukemia and Merkel Cell Carcinoma

Case Reports in Medicine ◽

10.1155/2020/4318638 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

András Folyovich ◽

Angéla Majoros ◽

Tamás Jarecsny ◽

Gitta Pánczél ◽

Zsuzsanna Pápai ◽

...

Keyword(s):

Bone Metastases ◽

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Cerebral Metastasis ◽

Merkel Cell ◽

Lymphoid Leukemia ◽

Chronic Lymphoid Leukemia ◽

History Of ◽

The Right ◽

The Brain

Background. Merkel cell carcinoma (MCC) is a rare primary neuroendocrine cutaneous tumor, rarely metastasizing to the brain. Chronic lymphoid leukemia (CLL) is a disease predisposing to MCC. According to previous reports, headache and focal neurological deficits suggest disease progression to the brain. We present a patient with MCC whose seizure was not elicited by a cerebral metastasis, but by bone metastases compressing the brain. Case Presentation. A 62-year-old female patient had a history of CLL. A lesion with the appearance of an atheroma was removed from the right upper arm. Histology confirmed the diagnosis of MCC. She was admitted to the neurology department with her first GM seizure. The cranial MRI/MRA showed bone metastases in the right parietal and both frontal areas, compressing the brain. Flow cytometry of CSF did not reveal metastasis of MCC. Conclusions. The case history of the patient was unique even among the rare cases of MCC with neurological involvement. The seizure was not elicited by a cerebral metastasis, but by bone metastases compressing the brain. In addition to patient history, clinical presentation and radiological findings enabled a suspected diagnosis of skull metastasis of MCC compressing the brain, causing symptomatic epileptic seizures.

Download Full-text

Cerebral metastasis of Merkel cell carcinoma following resection with negative margins and adjuvant external beam radiation: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02690-z ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Alex F. Grubb ◽

Elizabeth Hankollari

Keyword(s):

Cell Carcinoma ◽

Stereotactic Radiosurgery ◽

Merkel Cell Carcinoma ◽

Cerebral Metastasis ◽

External Beam Radiation ◽

External Beam ◽

Merkel Cell ◽

Beam Radiation ◽

History Of ◽

The Right

Abstract Background Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor of the skin. It is associated with advanced age, ultraviolet (UV) radiation, and Merkel cell polyomavirus. It has a predilection for the lymphatic system, but rarely spreads to the central nervous system. Case presentation A 71-year-old Caucasian man with a history of rheumatoid arthritis and MCC of the right lower eyelid and cheek presented with left-sided hemineglect and word-finding difficulty. Twenty months earlier he had undergone local excision of a 3 cm lesion with negative margins, negative sentinel lymph node biopsy, and external beam radiation. On presentation he was found to have a 6.3 cm mass in the right frontotemporal region. He underwent prompt resection, with pathological analysis consistent with metastatic MCC. He subsequently underwent stereotactic radiosurgery (SRS) and adjunctive immunotherapy with pembrolizumab. He has since tolerated the therapy well and is currently without neurological symptoms or evidence of recurrence. Conclusions Cerebral metastasis of MCC is a rare event and should be considered when a patient with a history of MCC presents with neurological symptoms. Optimal treatment regimens of these rare cases are unclear; however, prompt resection, stereotactic radiosurgery, and adjunctive immunotherapy have shown an initial positive response in this patient.

Download Full-text