Upper eyelid Merkel cell carcinoma treated with neoadjuvant chemotherapy and surgical excision

A 22-year-old woman who presented with a tumour of the upper eyelid with clinical, histological, immunohistochemical and ultrastructural features of a Merkel cell carcinoma is reported. This is a unique case of Merkel cell carcinoma in such a young patient. This neuroendocrine tumour is typically found in the elderly. It can grow rapidly, has the potential for local recurrence and early metastatic spread. The authors recommend wide resection of the primary site, which proved effective in this case.

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Nonmelanoma Cutaneous Head and Neck Cancer and Merkel Cell Carcinoma: Current Concepts, Advances, and Controversies

Journal of Clinical Oncology ◽

10.1200/jco.2014.60.7333 ◽

2015 ◽

Vol 33 (29) ◽

pp. 3338-3345 ◽

Cited By ~ 29

Author(s):

Sandro V. Porceddu ◽

Michael J. Veness ◽

Alexander Guminski

Keyword(s):

Cell Carcinoma ◽

Head And Neck ◽

Merkel Cell Carcinoma ◽

Surgical Excision ◽

Current Evidence ◽

Ageing Population ◽

Merkel Cell ◽

Tumor Boards ◽

Solar Radiation Exposure ◽

Cure Rates

Nonmelanoma skin cancer (NMSC) is the most common cancer worldwide and the most frequently observed malignancy in whites. Approximately 75% to 80% are basal cell carcinomas and 20% to 25% are squamous cell carcinomas. Incidence is increasing, partly reflecting an ageing population, and NMSC is more commonly seen in men. The predominant causative agent is ultraviolet solar radiation exposure, with the majority of cases occurring on the head and neck. Surgical excision is typically the treatment of choice, providing histopathologic information, high cure rates, and acceptable cosmetic and functional outcomes. Radiation therapy is reserved for cases where surgery is not the preferred choice or for high-risk cases where adjuvant therapy is recommended. Although overall mortality rates are low, patients with complex cases such as those with immunosuppression should be considered for management within multidisciplinary tumor boards. In contrast, Merkel cell carcinoma is a rare and aggressive malignancy, frequently arising on the head and neck in older whites, with a poorer prognosis. This article focuses on the current evidence guiding practice, recent advances, and areas of controversy in NMSC and Merkel cell carcinoma of the head and neck.

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Merkel Cell Carcinoma of the Upper Eyelid: When Reconstruction Becomes a Challenge

Archives of Plastic Surgery ◽

10.5999/aps.2015.42.2.257 ◽

2015 ◽

Vol 42 (2) ◽

pp. 257

Author(s):

Luca Grassetti ◽

Manuela Bottoni ◽

Matteo Torresetti ◽

Giovanni Di Benedetto

Keyword(s):

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Merkel Cell ◽

Upper Eyelid

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Unusual Ulcerated Merkel Cell Carcinoma of the Skin: Report of a Case

Tumori Journal ◽

10.1177/030089160609200618 ◽

2006 ◽

Vol 92 (6) ◽

pp. 555-558 ◽

Cited By ~ 2

Author(s):

Giorgio Lucandri ◽

Paolo Mazzocchi ◽

Bruno Bascone ◽

Marco Giordano ◽

Massimo Castaldi ◽

...

Keyword(s):

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Postoperative Radiotherapy ◽

Subcutaneous Fat ◽

Surgical Excision ◽

Prognostic Indicators ◽

Merkel Cell ◽

Biological Factors ◽

Axillary Lymphadenectomy ◽

Therapeutic Possibilities

Merkel cell carcinoma is an aggressive skin cancer, usually related to a severe prognosis. Treatment consists of wide surgical excision, adjuvant radiotherapy and/or polychemotherapy, but local-regional and distant relapses are common. Detection of histopathological and biological factors may select subgroups of patients suitable for different treatments. Herein we report the case of a patient treated for a wide bleeding and ulcerated Merkel cell carcinoma. Ulceration represents an uncommon feature because the tumor usually spreads from the dermis into subcutaneous fat, so it may be added to poor prognostic indicators. After surgical excision and postoperative radiotherapy, the patient recurred at regional nodes. Axillary lymphadenectomy was followed by courses of polychemotherapy. We obtained a satisfactory survival (31 months) by timing these different therapeutic possibilities.

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Merkel Cell Carcinoma: A Case-Report of Rare Presentation of Merkel Cell Carcinoma, Non-Indolent Proliferative Type, Polyomavirus-Negative: Hypothesis of MolecularPathogenesis

Advances in Hematology and Oncology Research ◽

10.33140/ahor.03.01.05 ◽

2020 ◽

Vol 3 (1) ◽

Keyword(s):

Case Report ◽

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Surgical Excision ◽

Molecular Pathogenesis ◽

Merkel Cell ◽

Rare Presentation ◽

Ki 67 ◽

Tissue Mass ◽

Pelvic Mri

Introduction: Merkel cell carcinoma (MCC) is a rare cutaneous indolent neuroendocrine cancer, arising from the Merkel cells of the stratum basalis, of the epidermis. This type of tumor commonly arises in sun-exposed areas, such as head, neck, and lower extremities. Here, we describe a rare presentation of non-indolent proliferative type Merkel cell carcinoma. Case Report: This is a case-report of a 70-year-old Caucasian man with no pertinent past medical history, presenting as a large painless violaceous necrotic irregular bordered rapidly growing lesion, reaching to 8x10x15 cm3, within one-year period, on the lower back region with surface ulceration. Pelvic MRI showed a multilobulated enhancing soft tissue mass measuring 8.7x10.4x15.1 cm3 at the left gluteal region with exophytic extension to the left paraspinal muscles. The patient was admitted, tangential surgical excision and debridement of left flank wound was performed with partial primary closure. Pathology showed features of Merkel cell, show diffuse dot-like positivity with CK20 and are negative for CK7, there is diffuse positivity with NSE, synaptophysin and CD56 with strong diffuse Ki-67 positivity noted in >65% of tumor cells. CD99 shows diffuse small faint dot-like paranuclear positivity. Discussion: Merkel cell carcinoma (MCC) is a rare, aggressive tumor that generally arises in sun-exposed regions. After an initial course of slow growth, starting as a painless violaceous non-pruritic domed-shaped lesion, the tumor becomes more aggressive, rapidly growing, with metastasis with local lymph nodes and regional tissue invasion. Sixty percent of tumors can rapidly grow within a three-month period after initial diagnosis. MCC is also clonally associated with is polyomavirus. MCC Contributing molecular pathogenesis is imperative to determining the causation of rare non-indolent MCC tumors, and its association with prognosis and treatment. In polyomavirus negative patients, consideration for molecular pathogenesis as etiology is imperative.

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Merkel cell carcinoma: a case report and literature review

Journal of Surgical Case Reports ◽

10.1093/jscr/rjz322 ◽

2019 ◽

Vol 2019 (11) ◽

Author(s):

Nicholas Mulchan ◽

Alberto Cayton ◽

Armand Asarian ◽

Philip Xiao

Keyword(s):

Case Report ◽

Literature Review ◽

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Surgical Excision ◽

Merkel Cell ◽

Cutaneous Malignancy ◽

Uncommon Presentation ◽

Prevalent Virus ◽

Time Of Presentation

Abstract Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy of neuroendocrine origin presenting as a painless, rapidly growing nodule. MCC often presents in elderly, fair-skinned individuals in sun-exposed areas. Diagnosis is often overlooked at time of presentation due to its rarity, but MCC is twice as deadly as malignant melanoma. There has been bigger interest in the disease due to increasing incidence and an association with the prevalent virus Merkel cell polyomavirus. This study describes an uncommon presentation of MCC as a right gluteal lesion in an Afro-Panamanian patient. The tumor was suspected to be fibrolipoma, but Immunohistochemistry revealed the diagnosis of MCC, as stains for CD56 and CK20 were positive. In addition to surgical excision, the patient was referred for adjuvant radiotherapy. This case report and literature review elucidates the clinical, histopathologic and management aspects of MCC, which will help in recognizing and treating these tumors.

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Secondary Merkel Cell Carcinoma Manifested in the Parotid

Case Reports in Dermatological Medicine ◽

10.1155/2013/960140 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4

Author(s):

M. Basati ◽

K. Kassam ◽

A. Messiha

Keyword(s):

Cell Carcinoma ◽

Head And Neck ◽

Merkel Cell Carcinoma ◽

Maxillofacial Surgery ◽

Neck Region ◽

Surgical Excision ◽

Malignant Tumour ◽

Selective Neck Dissection ◽

Merkel Cell

Background. Merkel cell carcinoma of the head and neck is a rare and aggressive malignant tumour. Both the dermatological and surgical colleagues should be aware of this entity as lesions usually present on sun exposed areas of the skin such as the head and neck.Main Observation and Treatment. A 69-year-old male originally presented to the maxillofacial surgery department with a growing lesion on the left eyebrow. Histological analysis confirmed Merkel cell carcinoma and consequently surgical excision was carried out. A follow-up PET/CT scan 2 years later demonstrated a hotspot in the left parotid gland. Fine needle aspiration and cytology revealed Merkel cell carcinoma. A subtotal parotidectomy left side with ipsilateral selective neck dissection levels I to III was carried out.Conclusions. Potential secondary Merkel cell carcinoma in the head and neck region should be taken into account when planning short- and long-term follow up for previously diagnosed patients. This followup should involve both dermatological and surgical colleagues.

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Merkel Cell Carcinoma: A Retrospective Study on 48 Cases and Review of Literature

Journal of Oncology ◽

10.1155/2012/749030 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 8

Author(s):

Fernando Cirillo ◽

Marco Vismarra ◽

Ines Cafaro ◽

Mario Martinotti

Keyword(s):

Quality Of Life ◽

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Surgical Excision ◽

Local Relapse ◽

Poor Quality ◽

Unknown Primary ◽

Rapid Progression ◽

Merkel Cell

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor of the skin. Fourty-eight patients with MCC were observed at the Rare Hormonal Tumors Group of Cremona Hospital, 15 of these with unknown primary site. Due to rarity of Merkel cell carcinoma, clinical experience is generally limited. Data from our series confirm the current recommendations. Wide surgical excision must be associated with radiotherapy also in early stages in order to avoid local relapse and the rapid progression of disease. In advanced stages chemotherapy is the standard despite the short duration of responses and poor quality of life. The data of our series, characterized by a high demand for second opinion, offer some insight about the real rarity of the tumor, the difficulty of managing of disease in our country secondary to a wrong cultural approach to the problem, the indiscriminate use of molecules unnecessary and often expensive, the lack of protocols, and the presence of guidelines often ignored. This results in very poor survival associated with a very low quality of life, requiring to find the right direction towards a correct management of disease.

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