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Valiga A, Tababa EJ, Chung HJ, Cha J. Merkel Cell Hyperplasia Versus Intraepidermal Merkel Cell Carcinoma: A Comparative Study of 2 Cases. Am J Dermatopathol 2023; 45:505-508. [PMID: 37249368 DOI: 10.1097/dad.0000000000002457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
ABSTRACT Intraepidermal Merkel cell hyperplasia and Merkel cell carcinoma represent 2 histologically similar-appearing diagnoses with significant differences regarding prognosis and management. We present 1 case of each diagnosis to highlight characteristic histopathologic and immunohistochemical features. Our case of Merkel cell hyperplasia was identified by its small intraepidermal nest of monomorphic cells without atypia or mitoses, which demonstrated cytoplasmic, rather than perinuclear dot, patterning on CK20 staining. This can be contrasted with our case of intraepidermal Merkel cell carcinoma, which, despite a lack of dermal extension, demonstrated large nests of pleomorphic cells with frequent mitoses and apoptoses. The diagnosis was further confirmed by immunohistochemistry because CK20 staining showed classic perinuclear dot patterning. By presenting both diagnoses in parallel, this comparison aims to underscore crucial histopathologic and immunohistochemical similarities and differences.
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Affiliation(s)
- Alexander Valiga
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA
| | - Erin Jane Tababa
- Department of Dermatology, Helathserv Los Manos Medical Center, Laguna, Philippines
| | - Hye Jin Chung
- Department of Dermatology, Harvard Medical School, Boston, MA; and
| | - Jisun Cha
- Dermatopathology Service, Schweiger Dermatology Group, New York, NY
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Richardson WM, Hohmann A, Usmani H, Lozeau D, Huston TL. CK20/CK7 Double Negative Merkel Cell Carcinoma In-Situ: A Case Report. J Cutan Pathol 2022; 49:947-956. [PMID: 35748574 DOI: 10.1111/cup.14284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/30/2022]
Abstract
An 83-year-old male with a history of both melanoma and non-melanoma skin cancers presented with a light pink non-ulcerated slightly raised 0.6 x 0.5 cm papule on his left lower extremity. Biopsy revealed a proliferation of intraepidermal round blue cells. On immunohistochemical staining, CD56, chromogranin, and pancytokeratin were faintly positive within the lesional population, while synaptophysin was strongly positive. CD45, CK5/6, CK7, CK20, Melan-A, SOX10, and TTF-1 stains were negative. There was no dermal component identified. A Merkel cell polyomavirus (MCPyV) stain was negative. Distant metastases and other in situ pathologies were excluded and a diagnosis of Merkel cell carcinoma in situ (MMCIS) was made. The majority of MCCIS lesions reported in the literature have been discovered amongst other non-melanoma neoplasms. Our findings of a MCCIS with purely intraepidermal involvements without the association with another squamous cell neoplasm is a rare finding. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | - Hunya Usmani
- Renaissance School of Medicine at Stony Brook University
| | - Daniel Lozeau
- Renaissance School of Medicine at Stony Brook University.,Department of Dermatology, Stony Brook University.,Department of Pathology, Stony Brook University.,Dermatology Section, Medicine Service, Northport VAMC
| | - Tara L Huston
- Renaissance School of Medicine at Stony Brook University.,Department of Dermatology, Stony Brook University.,Division of Plastic and Reconstructive Surgery, Stony Brook University
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Truong K, Goldinger SM, Chou S, Howle JR, Veness MJ, Fernandez-Peñas P, Varey AHR. Merkel cell carcinoma in situ: A systematic review of prognosis and management. Australas J Dermatol 2021; 63:e6-e12. [PMID: 34873684 DOI: 10.1111/ajd.13758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/04/2021] [Accepted: 11/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumour. While dermally invasive MCC is known to have a five-year survival of only 30-40%, the prognosis and management of MCC in situ (MCCis) is not widely reported. OBJECTIVE We present a systematic review to elucidate the prognosis and management of MCCis. METHODS We performed a systematic review, searching three databases to 01 June 2021. Case reports, cohort studies, clinical trials and literature reviews were considered for inclusion. RESULTS We identified 26 cases of MCCis published in the literature with a median age of 74 years and involving 19 males and 7 females. Most cases were on the face and neck (n = 17), followed by upper limb (n = 8) and lower limb (n = 1). Sentinel lymph node biopsy was performed in three patients, and all were negative. One subject underwent adjuvant radiotherapy. No MCCis-associated deaths were reported. CONCLUSION This review suggests that MCCis has an excellent prognosis with minimal, if any, risk of mortality and a very low risk of dermal invasion and recurrence when treated with wide local excision alone. Sentinel lymph node biopsy is unlikely to be useful for MCCis.
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Affiliation(s)
- Kelvin Truong
- Department of Dermatology, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Simone M Goldinger
- Department of Dermatology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Shaun Chou
- Department of Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Julie R Howle
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Surgical Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Michael J Veness
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Radiation Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Pablo Fernandez-Peñas
- Department of Dermatology, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexander H R Varey
- Department of Dermatology, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Plastic and Reconstructive Surgery, Westmead Hospital, Sydney, New South Wales, Australia.,Melanoma Institute Australia, Sydney, New South Wales, Australia
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