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Valentini R, Grant-Kels JM, Falcone M, Stewart CL. Merkel cell carcinoma and the eye. Clin Dermatol 2024; 42:381-389. [PMID: 38325726 DOI: 10.1016/j.clindermatol.2024.01.010] [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: 02/09/2024]
Abstract
Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine tumor with a poor five-year survival rate. Yearly cases have risen nearly 350% since the early 1980s, and these are predicted to increase as the overall US population ages. MCC of the eyelid is uncommon and can be misdiagnosed as other benign inflammatory and neoplastic eyelid disorders. Although MCC of the head and neck is often more aggressive than it is at other sites, eyelid MCC shows a lower disease-specific mortality rate. A biopsy is essential for accurate diagnosis, including an immunohistochemical panel of CK20 and TTF-1, although other markers may be necessary. Staging can be assessed clinically through physical examination findings and imaging and/or pathologically with sentinel lymph node biopsy or fine-needle aspiration. Pathologic staging more accurately predicts the prognosis. Eyelid MCC treatments include Mohs micrographic surgery to allow for complete clearance and adequate reconstruction of lost tissue, followed by adjuvant radiotherapy. In advanced disease, immunotherapies are preferred over traditional chemotherapy and are a subject of ongoing research.
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Affiliation(s)
- Rodolfo Valentini
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Madina Falcone
- Department of Surgery, Division of Ophthalmology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Campbell L Stewart
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
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Clinical and Epidemiological Characteristics of Merkel Cell Carcinoma in a Series of 38 Patients. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Dañino-García M, Domínguez-Cruz J, Pérez-Ruiz C, Conejo-Mir J, Pereyra-Rodríguez J. Características clínico-epidemiológicas del carcinoma de células de Merkel en una serie de 38 pacientes. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:360-365. [DOI: 10.1016/j.ad.2018.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/03/2018] [Accepted: 09/09/2018] [Indexed: 10/28/2022] Open
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Turkkan G, Agdogan O, Saynak M, Uygun AC, Ustun F. Recurrent Merkel cell carcinoma of the gluteal region: A case report. Dermatol Ther 2018; 32:e12749. [PMID: 30238578 DOI: 10.1111/dth.12749] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/28/2018] [Accepted: 09/16/2018] [Indexed: 11/28/2022]
Abstract
Merkel cell carcinoma (MCC) is a rare malignant tumor of the skin. The development of MCC on non-sun-exposed skin is extremely rare, with few cases reported in the literature. The present authors aimed to highlight the characteristic features and treatment options of this tumor. The present authors present a 50-year-old man who developed MCC on the left gluteal region (non-sun-exposed skin). After surgery with clear margins, adjuvant radiotherapy was given. Three months after radiotherapy, lymphatic recurrence was observed and he was treated with chemotherapy. On follow-up, systemic metastases were found and palliative treatment was planned.
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Affiliation(s)
- Gorkem Turkkan
- Department of Radiation Oncology, Edirne Sultan 1.Murat State Hospital, Edirne, Turkey
| | - Ozgur Agdogan
- Department of Plastic and Reconstructive Surgery, Namik Kemal University Faculty of Medicine, Tekirdag, Turkey
| | - Mert Saynak
- Department of Radiation Oncology, Trakya University Faculty of Medicine, Edirne, Turkey
| | - Arzu C Uygun
- Department of Pathology, Edirne Sultan 1.Murat State Hospital, Edirne, Turkey
| | - Funda Ustun
- Department of Nuclear Medicine, Trakya University Faculty of Medicine, Edirne, Turkey
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Marcoval J, Ferreres J. Clinical Features of Merkel Cell Carcinoma. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Marcoval J, Ferreres JR. Clinical Features of Merkel Cell Carcinoma. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:887. [PMID: 28669412 DOI: 10.1016/j.ad.2017.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 04/27/2017] [Accepted: 04/30/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- J Marcoval
- Servei de Dermatologia, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
| | - J R Ferreres
- Servei de Dermatologia, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, España
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Deinlein T, Richtig G, Schwab C, Scarfi F, Arzberger E, Wolf I, Hofmann-Wellenhof R, Zalaudek I. The use of dermatoscopy in diagnosis and therapy of nonmelanocytic skin cancer. J Dtsch Dermatol Ges 2016; 14:144-51. [PMID: 26819109 DOI: 10.1111/ddg.12903] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Today, dermatoscopy is an integral part of every clinical skin examination, as it markedly enhances the early detection of melanocytic and nonmelanocytic skin cancer (NMSC) compared to naked-eye inspection. Besides its diagnostic use, this noninvasive method is increasingly important in the selection of as well as the response assessment to various therapies used for NMSC, including basal cell carcinoma, actinic keratoses, squamous cell carcinoma, and also rare tumors such as Merkel cell carcinoma, angiosarcoma, or dermatofibrosarcoma protuberans. Thus, dermatoscopy is a valid tool for the preoperative assessment of tumor margins in basal cell carcinoma, but also for follow-up of actinic keratoses after topical treatment. The present article presents an overview on the use of dermatoscopy in the diagnosis and therapy of various types of NMSC.
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Affiliation(s)
- Teresa Deinlein
- Department of Dermatology and Venereology, Medical University Graz, Graz, Austria
| | - Georg Richtig
- Department of Dermatology and Venereology, Medical University Graz, Graz, Austria
| | - Christoph Schwab
- Department of Ophthalmology, Medical University Graz, Graz, Austria
| | - Federica Scarfi
- Department of Translational Medicine and Surgery, University of Florence, Florence, Italy
| | - Edith Arzberger
- Department of Dermatology and Venereology, Medical University Graz, Graz, Austria
| | - Ingrid Wolf
- Department of Dermatology and Venereology, Medical University Graz, Graz, Austria
| | | | - Iris Zalaudek
- Department of Dermatology and Venereology, Medical University Graz, Graz, Austria
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Acab JC, Kvatum W, Ebo C. A 76 year old male with an unusual presentation of merkel cell carcinoma. Int J Surg Case Rep 2016; 23:177-81. [PMID: 27161548 PMCID: PMC5022067 DOI: 10.1016/j.ijscr.2016.04.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 04/26/2016] [Accepted: 04/26/2016] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Merkel Cell Carcinoma is an aggressively malignant, neuroendocrine-derived, cutaneous neoplasm that commonly affects sun-exposed areas of the elderly population. MCC typically presents as a rapidly enlarging, painless nodule that is red to purple in color and located on sun exposed areas such as the head, neck and arms. Although rare, cases of MCC on non-sun exposed skin have been documented and typically have a worse prognosis. PRESENTATION OF CASE We report an atypical case of Merkel Cell Carcinoma originating in a non-sun exposed area of the body with evidence of distant metastasis. A 76-year-old male presented with complaints of a firm lesion in his left gluteal fold. DISCUSSION Clinical diagnosis of MCC is usually made from a combination of history and physical, skin and nodal examination, biopsy sample with H&E prep, and immunopanel. Treatment according to the National Comprehensive Cancer Network(®) (NCCN(®)) is directed by lymph node involvement and metastasis. CONCLUSION With initial unsuccessful treatment, his lesion was excised and pathological evaluation reported Merkel Cell Carcinoma (MCC). Despite further surgical excision and adjuvant chemotherapy, increased hyper metabolism was found in the left descending colon and left prostate of unknown etiology. There have been reports of metastasis of primary MCC to the small bowel mesentery; therefore new focal hyper metabolism cannot be delineated precisely as unrelated to MCC until biopsy and histochemical staining are performed.
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Affiliation(s)
- Joel C Acab
- Trinity School of Medicine, 5755 North Point Pkway #230, Alpharetta, GA 30022, United States.
| | - Wade Kvatum
- Trinity School of Medicine, 5755 North Point Pkway #230, Alpharetta, GA 30022, United States
| | - Chukwuma Ebo
- Mace Medical, 1124 Mace Ave, Essex, MD, 21221, United States
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Deinlein T, Richtig G, Schwab C, Scarfi F, Arzberger E, Wolf I, Hofmann-Wellenhof R, Zalaudek I. Der Einsatz der Dermatoskopie in der Diagnose und Therapie von nichtmelanozytären Hautkrebsformen. J Dtsch Dermatol Ges 2016. [DOI: 10.1111/ddg.120_12903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Teresa Deinlein
- Universitätsklinik für Dermatologie und Venerologie; Medizinische Universität Graz; Österreich
| | - Georg Richtig
- Universitätsklinik für Dermatologie und Venerologie; Medizinische Universität Graz; Österreich
| | - Christoph Schwab
- Universitäts-Augenklinik; Medizinische Universität Graz; Österreich
| | - Federica Scarfi
- Department of Translational Medicine and Surgery; University of Florence; Italy
| | - Edith Arzberger
- Universitätsklinik für Dermatologie und Venerologie; Medizinische Universität Graz; Österreich
| | - Ingrid Wolf
- Universitätsklinik für Dermatologie und Venerologie; Medizinische Universität Graz; Österreich
| | | | - Iris Zalaudek
- Universitätsklinik für Dermatologie und Venerologie; Medizinische Universität Graz; Österreich
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Saini AT, Miles BA. Merkel cell carcinoma of the head and neck: pathogenesis, current and emerging treatment options. Onco Targets Ther 2015; 8:2157-67. [PMID: 26316785 PMCID: PMC4548751 DOI: 10.2147/ott.s72202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Merkel cell carcinoma (MCC) is a relatively uncommon, neuroendocrine, cutaneous malignancy that often exhibits clinically aggressive features and is associated with a poor prognosis. It typically presents as a painless, rapidly enlarging, dome-shaped red or purplish nodule in a sun-exposed area of the head and neck or upper extremities. Our understanding of MCC has increased dramatically over the last several years and the pathogenesis continues to be an area of active research. The etiology is likely multifactorial with immunosuppression, UV-induced skin damage, and viral factors contributing to the development of MCC. The recent discovery of Merkel cell polyomavirus has allowed for at least one aspect of disease development to be much better understood. In most cases, treatment consists of wide local excision with adjuvant radiation therapy. The role of chemotherapeutics is still being defined. The recent advancement of knowledge regarding the pathogenesis of MCC has led to an explosion research into novel therapeutic agents and strategies. This review seeks to summarize the current body of literature regarding the pathogenesis of MCC and potential targets for future therapies.
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Affiliation(s)
- Alok T Saini
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, New York, NY, USA
| | - Brett A Miles
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Hospital, New York, NY, USA
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