Carcinoma, Merkel Cell/pathology* ; Humans ; Skin Neoplasms/pathology* ; Tongue ; Tongue Diseases

No abstract available.
Biopsy ; Carcinoma, Merkel Cell

No abstract available.
Carcinoma, Merkel Cell ; Fingers

Merkel cell carcinoma is a rare cutaneous carcinoma, featured by an aggressive clinical course and a mortality rate of 28% at 2 years. A 71-year-old female was affected by a 4.1-cm-wide locally advanced Merkel cell carcinoma of the upper eyelid, previously misdiagnosed as chalazion, with involvement of the extraocular muscles. Although the tumor showed a macroscopic spontaneous regression in size after the incisional biopsy, the mass was treated with neoadjuvant chemotherapy and surgical excision. Good functional and aesthetic result with preservation of the eyeball and absence of tumor recurrence were achieved at 3-year follow-up. In our experience, the combination of the inflammatory cascade due to the incisional biopsy and neoadjuvant chemotherapy led to the regression of a locally advanced large Merkel cell carcinoma of the eyelid.
Aged ; Biopsy ; Carcinoma, Merkel Cell ; Chalazion ; Drug Therapy ; Eyelid Neoplasms ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Mortality ; Muscles ; Neoadjuvant Therapy ; Recurrence ; Skin Neoplasms

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroectodermal carcinoma arising from mechanoreceptor Merkel cells. Multiple MCCs are even rarer. We report a case of two independent MCCs simultaneously present in the cheek of a patient, which were effectively and esthetically treated using a cheek flap. Punch biopsy performed in a 60-year-old woman admitted with a chief complaint of two skin-colored hard nodules in her left cheek, accompanied by an itching sensation, was suggestive of MCC. Accordingly, we performed sentinel lymph node biopsy through the modified Blair incision under general anesthesia, in cooperation with the head and neck surgery department. The defect was covered with a cheek flap by slightly extending the existing incision following wide excision with a safety margin of 1 cm. This paper is significant in that it introduces an effective reconstruction technique that maintains function using a cheek flap for the management of this rare case. In addition, this paper is the first to classify multiple MCCs according to the time of onset. We believe that this paper presents an effective alternative reconstruction technique with sentinel node biopsy through the modified Blair incision.
Anesthesia, General ; Biopsy ; Carcinoma, Merkel Cell ; Cheek ; Female ; Head ; Humans ; Mechanoreceptors ; Merkel Cells ; Middle Aged ; Neck ; Neural Plate ; Pruritus ; Sensation ; Sentinel Lymph Node Biopsy ; Surgical Flaps

BACKGROUND: Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients. METHODS: We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis. RESULTS: Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a split-thickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up. CONCLUSIONS: We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.
Asian Continental Ancestry Group ; Carcinoma, Merkel Cell ; Diagnosis ; Follow-Up Studies ; Head ; Humans ; Lost to Follow-Up ; Lymph Nodes ; Mohs Surgery ; Neck ; Prognosis ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Sentinel Lymph Node Biopsy ; Skin ; Transplants

Merkel cell carcinoma (MCC) is a relatively rare and aggressive cutaneous neuroendocrine malignancy. It is characterized by high rates of recurrence and metastasis, both to regional lymph nodes and to distant locations. Its characteristic clinical manifestation is a single, painless, hard, erythematous nodule on a sun-exposed area, particularly in older men. Surgical management of both the primary site and the sentinel lymph node is the standard of care. In this article, we describe the diagnosis and treatment of a case of MCC in the left cheek.
Carcinoma, Merkel Cell ; Cheek ; Diagnosis ; Head ; Humans ; Lymph Nodes ; Male ; Merkel Cells ; Neck ; Neoplasm Metastasis ; Recurrence ; Skin Neoplasms ; Standard of Care

Merkel cell carcinoma (MCC) is a rare aggressive skin cancer with the mortality rate of 33%. MCC was first described by Toker in 1972 as a trabecular cell carcinoma and is classified as a neuroendocrine tumor similar to small cell lung carcinoma and melanoma. The pathogenesis of MCC remains largely unknown. However, ultraviolet radiation and immunosuppression are likely to play a significant pathogenic role. The primary skin lesion is usually asymptomatic and it typically presents as a red or purple dome-shaped nodule. The management of MCC is controversial, however, local wide excision followed by radiotherapy is accepted as the primary treatment modality. The regional draining nodal basin is the most common site for recurrence. Therefore, sentinel lymph node biopsy is recommended in all cases, except for the clinically node-negative cases. We herein report two cases of MCC on the left cheek with different clinical manifestations.
Carcinoma, Merkel Cell* ; Cheek* ; Immunosuppression ; Melanoma ; Mortality ; Neuroendocrine Tumors ; Radiotherapy ; Recurrence ; Sentinel Lymph Node Biopsy ; Skin ; Skin Neoplasms ; Small Cell Lung Carcinoma

PURPOSE: To report a case of poorly differentiated neuroendocrine carcinoma of the eyelid. CASE SUMMARY: A 70-year-old male presented with a 5-month history of a right upper eyelid mass. The mass appeared as 1.2 × 1.2 cm on the right upper eyelid. A mass excision was performed under frozen section control. The tumor was completely excised with a safety margin clearance and an upper eyelid reconstruction was performed. Histopathological examination revealed a tumor composed of small atypical cells which showed a high nuclear/cytoplasm ratio, nuclear molding, and increased mitotic activity. Immunohistochemical examination revealed positive reactivity for Ki-67, synaptophysin, CD56, and negative reactivity for chromogranin, cytokeratin 20, and thyroid transcription factor-1. CONCLUSIONS: Primary neuroendocrine carcinoma of the eyelid is extremely rare, but the tumor has high malignancy and readily metastasizes. Poorly differentiated neuroendocrine carcinoma should be considered in the differential diagnosis of a rapidly growing eyelid mass.
Aged ; Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Carcinoma, Small Cell ; Diagnosis, Differential ; Eyelids ; Frozen Sections ; Fungi ; Humans ; Keratin-20 ; Male ; Synaptophysin ; Thyroid Gland

Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine carcinoma of the skin that shows locoregional or distant metastasis. Metastasis of MCC to body cavity effusion is extremely rare; only three cases have been reported so far. Metastatic MCC in effusion cytology shows small blue round cells with fine stippled chromatin like other small blue round cell tumors such as small cell lung carcinoma or lymphoma. The diagnosis of metastatic MCC can grant patients good chances at recently advanced therapeutic options. Here, we present a case of metastatic MCC to pleural effusion with characteristic single file-like pattern.
Carcinoma, Merkel Cell ; Carcinoma, Neuroendocrine ; Chromatin ; Diagnosis ; Financing, Organized ; Humans ; Lymphoma ; Neoplasm Metastasis ; Pleural Effusion ; Skin ; Small Cell Lung Carcinoma