异时原发乳腺癌和皮肤Merkel细胞癌1例及文献复习

Heterochronia primary breast cancer and cutaneous Merkel cell carcinoma:1 case report and literature review

目的:探讨皮肤Merkel细胞癌的诊断及鉴别诊断、治疗及预后。方法:对1例异时原发乳腺癌和皮肤Merkel细胞癌患者的临床病史、肿瘤组织的病理免疫组化表达及治疗过程进行回顾性分析。结果:本例Merkel细胞癌患者表现为乳腺癌术后3年出现皮肤肿块,无乳腺癌复发和转移证据;免疫组化表达神经内分泌标志物和细胞角蛋白20(CK20)。于术后6月复发,术后4年死亡。结论:Merkel细胞癌罕见且进展快,即使综合治疗后仍有局部复发和远处转移的倾向,预后差。诊断主要依靠病理,免疫组化染色有助于鉴别诊断。临床上需结合病史与第一原发癌的转移相鉴别。

Objective： To study diagnosis, differentiated diagnosis, therapy and prognosis of cutaneous Merkel cell carcinoma. Methods. Review clinical data,immunohistochemical expression and the therapy process in 1 case of heterochronia primary breast cancer and cutaneous Merkel cell carcinoma. Results：This patient manifested cutaneous masses at the third year after breast cancer resection, no evidence of metastasis and recrudescence of breast cancer; expressed neuroendocrine markers and CK 20 in immunohistochemical staining. The patient relapsed at the sixth month and died at the fourth year after operation. Conclusion：Merkel cell carcinoma is infrequent and evolve soon. It will trend to recur at locol and transfer beyond even after integrated therapy. It＇s prognosis is bad and diagnoses mainly depends on pathology, immunohistochemical staining is useful for diagnosis and differentiation. It needs to be differentiated from metastasis of the first primary cancer combining with the clinical records.