Limits...
Merkel cell carcinoma of the upper extremity: case report and an update.

Papamichail M, Nikolaidis I, Nikolaidis N, Glava C, Lentzas I, Marmagkiolis K, Karassavsa K, Digalakis M - World J Surg Oncol (2008)

Bottom Line: No postoperative radiation or adjuvant chemotherapy was given and within 9 years follow up no recurrence was reported.Although most cases present as localized disease treatment should be definitive due to high rates of local or systemic recurrence.Even when locoregional control is achieved close surveillance is required due to high rates of relapse.

View Article: PubMed Central - HTML - PubMed

Affiliation: General Hospital of Athens, Asklipion Voulas, Athens, Greece. mp2006gr@yahoo.co.uk

ABSTRACT

Background: Merkel cell carcinoma is a rare but aggressive cutaneous primary small cell carcinoma. It is commonly seen in elderly affecting the head, neck, and extremities. Macroscopically may be difficult to distinguish MCC from other small cells neoplasms especially oat cell carcinoma of the lung.

Case presentation: It is presented a case report concerning a 72 years old male with a MMC on the dorsal aspect of the right wrist. The patient underwent a diagnostic excisional biopsy and after the histological confirmation of the diagnosis a second excision was performed to achieve free margins. No postoperative radiation or adjuvant chemotherapy was given and within 9 years follow up no recurrence was reported.

Conclusion: Although most cases present as localized disease treatment should be definitive due to high rates of local or systemic recurrence. Treatment includes excision of the lesion, lymphadenectomy, postoperative radiotherapy and chemotherapy depending on the stage of the disease. Even when locoregional control is achieved close surveillance is required due to high rates of relapse.

Show MeSH

Related in: MedlinePlus

EMA x 400
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2279132&req=5

Figure 4: EMA x 400

Mentions: An excisional biopsy was performed. Microscopical examination of the lesion revealed the invasion of dermis and subcutaneous tissue by a small cell solid tumor with diffuse pattern of infiltration (Figure 2). The excisional margins were positive although dermal lymphatics were intact and no exceeding to the adjacent structures such us, veins, tendons or nerves was discovered. The tumor cells were small, with scanty acidophilic cytoplasm, round vescicular nuclei and multiple nucleoli (Figure 3). Mitotic figures were numerous. In immunohistochemical examination, the tumor cells showed diffuse positivity for Epithelial Membrane Antigen (EMA, Figure 4) and Neuron Specific Antigen (NSE, Figure 5). Lymphatic Common Antigen (LCA), Thyroid Transcription Factor – 1 (TTF-1) and CD99 were negative. Based on to these histological and immunohistochemical features, diagnosis of Merkel Cell Tumor was established.


Merkel cell carcinoma of the upper extremity: case report and an update.

Papamichail M, Nikolaidis I, Nikolaidis N, Glava C, Lentzas I, Marmagkiolis K, Karassavsa K, Digalakis M - World J Surg Oncol (2008)

EMA x 400
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2279132&req=5

Figure 4: EMA x 400
Mentions: An excisional biopsy was performed. Microscopical examination of the lesion revealed the invasion of dermis and subcutaneous tissue by a small cell solid tumor with diffuse pattern of infiltration (Figure 2). The excisional margins were positive although dermal lymphatics were intact and no exceeding to the adjacent structures such us, veins, tendons or nerves was discovered. The tumor cells were small, with scanty acidophilic cytoplasm, round vescicular nuclei and multiple nucleoli (Figure 3). Mitotic figures were numerous. In immunohistochemical examination, the tumor cells showed diffuse positivity for Epithelial Membrane Antigen (EMA, Figure 4) and Neuron Specific Antigen (NSE, Figure 5). Lymphatic Common Antigen (LCA), Thyroid Transcription Factor – 1 (TTF-1) and CD99 were negative. Based on to these histological and immunohistochemical features, diagnosis of Merkel Cell Tumor was established.

Bottom Line: No postoperative radiation or adjuvant chemotherapy was given and within 9 years follow up no recurrence was reported.Although most cases present as localized disease treatment should be definitive due to high rates of local or systemic recurrence.Even when locoregional control is achieved close surveillance is required due to high rates of relapse.

View Article: PubMed Central - HTML - PubMed

Affiliation: General Hospital of Athens, Asklipion Voulas, Athens, Greece. mp2006gr@yahoo.co.uk

ABSTRACT

Background: Merkel cell carcinoma is a rare but aggressive cutaneous primary small cell carcinoma. It is commonly seen in elderly affecting the head, neck, and extremities. Macroscopically may be difficult to distinguish MCC from other small cells neoplasms especially oat cell carcinoma of the lung.

Case presentation: It is presented a case report concerning a 72 years old male with a MMC on the dorsal aspect of the right wrist. The patient underwent a diagnostic excisional biopsy and after the histological confirmation of the diagnosis a second excision was performed to achieve free margins. No postoperative radiation or adjuvant chemotherapy was given and within 9 years follow up no recurrence was reported.

Conclusion: Although most cases present as localized disease treatment should be definitive due to high rates of local or systemic recurrence. Treatment includes excision of the lesion, lymphadenectomy, postoperative radiotherapy and chemotherapy depending on the stage of the disease. Even when locoregional control is achieved close surveillance is required due to high rates of relapse.

Show MeSH
Related in: MedlinePlus