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Merkel cell carcinoma: an illustrative case and review.

Marek L, Grzanka A, Chmielowska E, Jankowski M, Schwartz RA, Czajkowski R - Postepy Dermatol Alergol (2014)

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Affiliation: Department of Dermatology, Sexually Transmitted Diseases and Immunodermatology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Poland. Head of Department: Rafał Czajkowski MD, PhD, DSc.

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Merkel cell carcinoma has a high propensity for local recurrence, lymphatic spread and distal metastases... Metastases are usually found in the skin (28%), liver (13%), bones (10%), and brain (6%)... Routine histological examination may be of limited diagnostic value... Immunohistochemical staining, particularly against cytokeratin 20 (CK20) or chromogranin A, increase the effectiveness of MCC diagnosis... The patient was staged IIC T4 N0 M0, where IIC is for primary tumors > 2 cm in size with extracutaneous invasion, T4 stands for primary tumor invading the bone, muscle, fascia, or cartilage; N0 – no regional lymph node metastasis and M0 – no distant metastases... In the patient presented in this report, the incidence of tumors on both legs and the history of spontaneously resolving nodules may indicate MCC metastases without an apparent primary tumor... Enlarged inguinal lymph nodes in our patient could indicate changes in tumor spread via lymphatic vessels... We believe that coexistence of MCC with post-thrombotic syndrome in our patient may explain ulceration of MCC tumor in this case... The prognosis in MCC is usually poor... The size of the primary tumor below 2.0 cm is associated with better prognosis, unfortunately, because of the very rapid proliferation of tumor cells, and diagnostic difficulties delaying diagnosis, in most cases, patients are diagnosed with MCC at the stage when the primary lesion exceeds 2.0 cm... One can consider both the chemotherapy and radiotherapy in order to reduce the tumor mass prior to surgery in stages IIC to IIIB... In our patient, due to the presence of coexisting diseases and general condition, only surgical treatment was applied... Because of its similarity to small lung cancer, recommended chemotherapy protocols are cisplatin with etoposide or doxorubicin and cyclophosphamide or ifosfamide... The value of adjuvant radiotherapy has been confirmed with meta-analysis.

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Blue-red colored, hard and painful to the touch skin tumors of the left lower leg diagnosed as MCC
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Figure 0001: Blue-red colored, hard and painful to the touch skin tumors of the left lower leg diagnosed as MCC

Mentions: A 74-year-old woman presented to our clinic with blue-red colored, well-demarcated skin tumors ranging from 0.5 cm to 2.0 cm in diameter located on the left lower extremity. Lesions were hard and painful on palpation (Figure 1). The enlarged inguinal lymph nodes were present bilaterally. Additionally the patient had a history of arterial hypertension, type 2 diabetes, rheumatoid arthritis and post-thrombotic syndrome.


Merkel cell carcinoma: an illustrative case and review.

Marek L, Grzanka A, Chmielowska E, Jankowski M, Schwartz RA, Czajkowski R - Postepy Dermatol Alergol (2014)

Blue-red colored, hard and painful to the touch skin tumors of the left lower leg diagnosed as MCC
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4221346&req=5

Figure 0001: Blue-red colored, hard and painful to the touch skin tumors of the left lower leg diagnosed as MCC
Mentions: A 74-year-old woman presented to our clinic with blue-red colored, well-demarcated skin tumors ranging from 0.5 cm to 2.0 cm in diameter located on the left lower extremity. Lesions were hard and painful on palpation (Figure 1). The enlarged inguinal lymph nodes were present bilaterally. Additionally the patient had a history of arterial hypertension, type 2 diabetes, rheumatoid arthritis and post-thrombotic syndrome.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Sexually Transmitted Diseases and Immunodermatology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Poland. Head of Department: Rafał Czajkowski MD, PhD, DSc.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Merkel cell carcinoma has a high propensity for local recurrence, lymphatic spread and distal metastases... Metastases are usually found in the skin (28%), liver (13%), bones (10%), and brain (6%)... Routine histological examination may be of limited diagnostic value... Immunohistochemical staining, particularly against cytokeratin 20 (CK20) or chromogranin A, increase the effectiveness of MCC diagnosis... The patient was staged IIC T4 N0 M0, where IIC is for primary tumors > 2 cm in size with extracutaneous invasion, T4 stands for primary tumor invading the bone, muscle, fascia, or cartilage; N0 – no regional lymph node metastasis and M0 – no distant metastases... In the patient presented in this report, the incidence of tumors on both legs and the history of spontaneously resolving nodules may indicate MCC metastases without an apparent primary tumor... Enlarged inguinal lymph nodes in our patient could indicate changes in tumor spread via lymphatic vessels... We believe that coexistence of MCC with post-thrombotic syndrome in our patient may explain ulceration of MCC tumor in this case... The prognosis in MCC is usually poor... The size of the primary tumor below 2.0 cm is associated with better prognosis, unfortunately, because of the very rapid proliferation of tumor cells, and diagnostic difficulties delaying diagnosis, in most cases, patients are diagnosed with MCC at the stage when the primary lesion exceeds 2.0 cm... One can consider both the chemotherapy and radiotherapy in order to reduce the tumor mass prior to surgery in stages IIC to IIIB... In our patient, due to the presence of coexisting diseases and general condition, only surgical treatment was applied... Because of its similarity to small lung cancer, recommended chemotherapy protocols are cisplatin with etoposide or doxorubicin and cyclophosphamide or ifosfamide... The value of adjuvant radiotherapy has been confirmed with meta-analysis.

No MeSH data available.


Related in: MedlinePlus