2012, Number 1
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ABSTRACTBackground: Merkel cell carcinoma is an aggressive neuroendocrine cell carcinoma arising in the epidermis of patients aged ›60 years. This lesion is found in sun-exposed areas and presents as a small violet raised nodule. It is usually painless and rapidly growing. Although its clinical presentation and characteristic histology are usually sufficient, immunohistochemical features are helpful in making an accurate diagnosis.
Clinical case: We present the case of a 62-year-old male with epidermoid carcinoma of the lung who was treated with surgery and local radiation for 2 months. He presented a painless 8-cm subcutaneous mass of some weeks of evolution, without inflammatory signs. Computerized tomography demonstrated a mass of probable lymph node origin. Fine-needle aspiration biopsy (FNAB) reported malignant cells and excisional surgery of the mass was performed, revealing a subcutaneous Merkel cell carcinoma.
Conclusions: Merkel cell carcinoma is a rare entity that develops in mature patients, often in sun-exposed areas, and presents cutaneous injury in intact skin. Definitive diagnosis is done using immunohistochemistry.
Rockville Merkel Cell Carcinoma Group. Merkel cell carcinoma: recent progress and current priorities on etiology, pathogenesis, and clinical management. J Clin Oncol 2009;27:4021-4026.
Ott MJ, Tanabe KK, Gadd MA. Multimodality management of Merkel cell carcinoma. Arch Surg 1999;134:388-392.
Swann MH, Yoon J. Merkel cell carcinoma. Semin Oncol 2007;34:51-56.
Dancey AL, Rayatt SS, Soon C, Ilchshyn A, Brown I, Srivastava S. Merkel cell carcinoma: a report of 34 cases and literature review. J Plast Reconstr Aesthet Surg 2006;59:1294-1299.
Sarma DP, Heagley DE, Chalupa J, Cox M, Shehan JM. An unusual clinical presentation of Merkel Cell carcinoma: a case report. Case Report Med 2010. ID 905414. doi:10.1155/2010/905414.
Ruan JH, Reeves M. A Merkel cell carcinoma treatment algorithm. Arch Surg 2009;144:582-585.
Zucchi S. Merkel cell carcinoma: case report and literature review, from a remote region of France. Rural Remote Health 2009;9:1072.
Van Gele M, Leonard JH, Van Roy V. Frequent allelic loss at 10 q23: low incidence of PIEN mutations in Merkell cell carcinoma. Int J Cancer 2001;92:409-413.
Mogha A, Fautrel A, Mouchet N, Guo N, Corre S, Adamski H, et al. Merkel cell polyomavirus small T antigen mRNA level is increased following in vivo UV-radiation. PloS One 2010;2:5.
Cires Benzanilla M, González CL, Jiménez FJ, Rubio T, Amat I. Merkel cell carcinoma. On one case. An Sist Sanit Navar 2008;31:193-196.
Huang GS, Chang WC, Lee HS, Taylor JA, Cheng TY, Chen CY. Merkel cell carcinoma arising from the subcutaneous fat of the arm with intact skin. Dermatol Surg 2005;31:717-719.
Lawenda BD, Thirenger K, Foss RD. Merkel cell carcinoma arising in the head and neck. Am J Clin Oncol 2001;24:35-42.
Gollard R, Weber R, Kosty M. Merkel cell carcinoma: review of 22 cases with surgical, pathologic, and therapeutic considerations. Am Cancer Soc 2000;88:1842-1851.
Santos-Gorjón P, Morales-Martin AC, Blanco-Pérez P, Gómez- González JL, del Pozo-de Dios JC, Romo-Melgar A. Carcinoma de células de Merkel: presentación de 5 casos y revisión de la literatura. Acta Otorrinolaringol Esp 2011. doi:10.1016/j.otorri. 2010.12.009.