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Bystricky B, Kohutek F, Miklatkova Z, Sedlacek T, Gal V, Lohajova Behulova R. Spontaneous Regression of Merkel Cell Carcinoma: Case Report. Int Med Case Rep J 2021; 14:711-717. [PMID: 34629908 PMCID: PMC8495228 DOI: 10.2147/imcrj.s329545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/19/2021] [Indexed: 01/02/2023] Open
Abstract
Merkel cell carcinoma (MCC) is a rare skin neuroendocrine tumor presumably arising from Merkel cells in the basal layer of epidermis. It is an aggressive tumor predominantly found on the head and neck area of elderly people, with a mortality rate around 41% for all stages. Complete spontaneous regression of MCC is seldom observed, mostly in elderly women. We describe complete spontaneous regression of large, histologically confirmed MCC in an elderly woman after biopsy, which occurred incidentally, while waiting for radical surgery with skin flap. Next-generation sequencing with SOPHiA Solid Tumor Plus Solution did not reveal any relevant gene mutations or rearrangements. An update of literature for these very rare cases is provided.
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Affiliation(s)
- Branislav Bystricky
- Oncology Department, Faculty Hospital Trencin, Trencin, Slovakia and Faculty of Healthcare, Alexander Dubcek University of Trencin, Trencin, Slovakia
| | - Filip Kohutek
- Oncology Department, Faculty Hospital Trencin, Trencin, Slovakia
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Kobayashi Y, Nakamura M, Kato H, Morita A. Distant recurrence of Merkel cell carcinoma after spontaneous regression. J Dermatol 2018; 46:e133-e134. [DOI: 10.1111/1346-8138.14652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Yuka Kobayashi
- Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Motoki Nakamura
- Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Hiroshi Kato
- Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Akimichi Morita
- Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
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Walsh NM, Fleming KE, Hanly JG, Dakin Hache K, Doucette S, Ferrara G, Cerroni L. A morphological and immunophenotypic map of the immune response in Merkel cell carcinoma. Hum Pathol 2016; 52:190-6. [PMID: 26980039 DOI: 10.1016/j.humpath.2016.02.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/01/2016] [Accepted: 02/04/2016] [Indexed: 11/25/2022]
Abstract
The susceptibility of Merkel cell carcinoma to the host immune response has prompted a search for effective immunotherapy. CD8-positive T lymphocytes are considered key effectors of this response, but the cellular infiltrates also harbor tumor-protective agents. By developing a comprehensive morphological and immunophenotypic map of tumor-infiltrating lymphocytes (TILS) in Merkel cell carcinoma, we aimed to establish a useful template for future studies. Twenty-two cases (mean age, 79years [range, 52-95]; male-female ratio, 10:12) were studied. TILS were categorized as brisk (7), nonbrisk (9), and absent(6). Merkel cell polyomavirus (MCPyV)-positive (16) and -negative (6) cases were included, as were those with pure (18) and combined (4) morphologies. One MCPyV+ case had undergone spontaneous regression. Immunohistochemical markers included CD3, CD4, CD8, CD20, CD68, FoxP3, PD-1, and CD123. Statistical analysis used Fisher exact tests and Spearman correlations. There was a significant correlation between brisk TILs and MCPyV+ status (P=.025). CD8+ T lymphocytes predominated, were present in significantly higher proportions in brisk infiltrates (P=.003), and showed a significant predilection for the intratumoral environment (P=.003). Immune inhibitors including T regulatory cells (FOXP3+) and PD-1+ "exhausted" immunocytes were present in lower proportions. Our findings support (1) the link between a brisk immune response and MCPyV positivity, (2) the supremacy of CD8+ cells in effecting immunity, and (3) the incorporation of immune inhibitors within the global infiltrate. Efforts to therapeutically arm the "effectors" and disarm the "detractors" are well focused. These will likely have the greatest impact on MCPyV-positive cases.
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Affiliation(s)
- Noreen M Walsh
- Department of Pathology, Queen Elizabeth II Health Sciences Center, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, B3H 1V8, Canada; Dalhousie University, Halifax, Nova Scotia, B3H 1V8, Canada; Department of Medicine, Queen Elizabeth II Health Sciences Center, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, B3H 1V8, Canada.
| | - Kirsten E Fleming
- Department of Pathology, Queen Elizabeth II Health Sciences Center, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, B3H 1V8, Canada; Dalhousie University, Halifax, Nova Scotia, B3H 1V8, Canada
| | - John G Hanly
- Department of Pathology, Queen Elizabeth II Health Sciences Center, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, B3H 1V8, Canada; Dalhousie University, Halifax, Nova Scotia, B3H 1V8, Canada; Department of Medicine, Queen Elizabeth II Health Sciences Center, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, B3H 1V8, Canada
| | - Kelly Dakin Hache
- Department of Pathology, Queen Elizabeth II Health Sciences Center, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, B3H 1V8, Canada; Dalhousie University, Halifax, Nova Scotia, B3H 1V8, Canada
| | - Steve Doucette
- Dalhousie University, Halifax, Nova Scotia, B3H 1V8, Canada; Research Methods Unit, Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, B3H 1V7, Canada
| | - Gerardo Ferrara
- Anatomic Pathology Unit, Gaetano Rummo Hospital, Benevento, Italy; Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Lorenzo Cerroni
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
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