Lymph node metastasis of Merkel cell carcinoma without known cutaneous primary - case report
Authors:
Arpád Szabó 1; Igor Richter 2,7; Dana Frydrychová 3; Martina Saláková 4,5; Tomáš Jirásek 1,6
Authors place of work:
Ústav patologie 3. LF UK a Fakultní nemocnice Královské Vinohrady, Praha
1; Komplexní onkologické centrum, Krajská nemocnice Liberec, a. s.
2; Kožní oddělení, Krajská nemocnice Liberec, a. s.
3; Národní referenční laboratoř pro papilomaviry a polyomaviry, Ústav hematologie a krevní transfuze, Praha.
4; Katedra genetiky a mikrobiologie, Přírodovědecká fakulta, Univerzita Karlova, Praha
5; Oddělení patologie, Krajská nemocnice Liberec, a. s.
6; Onkologická klinika 1. LF UK a Thomayerovy nemocnice, Praha
7
Published in the journal:
Čes.-slov. Patol., 53, 2017, No. 3, p. 135-138
Category:
Original Article
Summary
Merkel cell carcinoma is a rare cutaneous tumor with an aggressive clinical course. In most cases it is associated with Merkel cell polyomavirus infection. Exceptionally, the tumor can present as a lymph node metastasis without a discernible cutaneous primary.
In this report we present the case of a 42 year-old man with inguinal lymphadenopathy, histologically consistent with Merkel cell carcinoma. Tumor cells expressed immunohistochemically chromogranin-A, synaptophysin and displayed dot-like positivity for cytokeratin 20. The genome of MCPyV in neoplastic cells was detected using real-time PCR. A cutaneous primary has not been identified neither during the dermatologic examination, nor with PET CT scan.
Keywords:
Merkel cell carcinoma – lymph node metastasis – tumor of unknown primary origin
Zdroje
1. LeBoit P, Burg G, Weedon D, et al. Skin Tumours, World Health Organization Classification of Tumours (4th ed.). Lyon: IARCpress; 2006: 272-273.
2. Jirásek T, Matěj R, Pock L, Knotková I, Mandys V. Karcinom z Merkelových buněk – imunohistochemická studie v souboru 11 pacientů. Cesk Patol 2009; 45(1): 9-13.
3. Feng H, Shuda M, Chang Y, Moore PS. Clonal integration of a polyomavirus in human Merkel cell carcinoma. Science 2008; 319(5866): 1096-1100.
4. Toracchio S, Foyle A, Sroller V, Reed JA, Wu J, Kozinetz CA, Butel JS. Lymphotropism of Merkel cell polyomavirus infection, Nova Scotia, Canada. Emerg Infect Dis 2010; 16 (11):1702-1709.
5. Rodig SJ, Cheng J, Wardzala J, et al. Improved detection suggests all Merkel cell carcinomas harbor Merkel polyomavirus. J Clin Invest 2012; 122(12): 4645-4653.
6. Saláková M, Košlabová E, Vojtěchová Z, Tachezy R, Šroller V. Detection of human polyomaviruses MCPyV, HPyV6, and HPyV7 in malignant and non-malignant tonsillar tissues. J Med Virol 2016; 88(4): 695-702.
7. Rotnáglová E, Tachezy R, Saláková M, et al. HPV involvement in tonsillar cancer: Prognostic significance and clinically relevant markers. International Journal of Cancer 2011; 129: 101-110.
8. Heath M, Jaimes N, Lemos B, Mostaghimi A, Wang LC, Peñas PF, Nghiem P. Clinical characteristics of Merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features. J Am Acad Dermatol 2008; 58(3): 375-381.
9. Deneve JL, Messina JL, Marzban SS, et al. Merkel cell carcinoma of unknown primary origin. Ann Surg Oncol 2012; 19(7): 2360-2366.
10. Cirillo F. Spontaneous Regression of Primitive Merkel Cell Carcinoma. Rare Tumors 2015; 7(4): 5961.
11. Pan Z, Chen Y, Wu X, et al. Merkel cell carcinoma of lymph node with unknown primary has a significantly lower association with Merkel cell polyomavirus than its cutaneous counterpart. Mod Pathol 2014; 27(9): 1182-1192.
12. Toker C. Trabecular carcinoma of the skin. Arch Dermatol 1972; 105(1): 107-110.
13. Tang CK, Toker C. Trabecular carcinoma of the skin: an ultrastructural study. Cancer 1978; 42(5): 2311-2321.
14. Erovic I, Erovic BM. Merkel cell carcinoma: the past, the present, and the future. J Skin Cancer 2013; Article ID 929364.
15. Tilling T, Moll I. Which are the cells of origin in Merkel cell carcinoma? J Skin Cancer 2012; Article ID 680410.
16. de Biase D, Ragazzi M, Asioli S, Eusebi V. Extracutaneous Merkel cell carcinomas harbor polyomavirus DNA. Hum Pathol 2012; 43(7): 980-985.
17. Wang TS, Byrne PJ, Jacobs LK, Taube JM. Merkel cell carcinoma: update and review. Semin Cutan Med Surg 2011; 30: 48-56.
18. Ko JS, Prieto VG, Elson PJ, et al. Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients. Mod Pathol 2016; 29(2): 122-130.
19. Chen KT, Papavasiliou P, Edwards K, et al. A better prognosis for Merkel cell carcinoma of unknown primary origin. Am J Surg 2013; 206(5): 752-757.
20. Tarantola TI, Vallow LA, Halyard MY, et al. Unknown primary Merkel cell carcinoma: 23 new cases and a review. J Am Acad Dermatol 2013; 68(3): 433-440.
21. Kotteas EA, Pavlidis N. Neuroendocrine Merkel cell nodal carcinoma of unknown primary site: management and outcomes of a rare entity. Crit Rev Oncol Hematol 2015; 94(1): 116-121.
Štítky
Anatomical pathology Forensic medical examiner ToxicologyČlánok vyšiel v časopise
Czecho-Slovak Pathology
2017 Číslo 3
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