面部Merkel细胞癌临床病理观察

Clinicopathological observation of facial Merkel cell carcinoma

目的:探讨面部Merkel细胞癌(Merkel cell carcinoma,MCC)临床病理特征。方法:观察2例面部Merkel细胞癌患者的临床病理特点和免疫组化结果,分析其临床特点并复习文献。结果:2例老年女性患者无意中发现面部质硬肿块,逐渐增大,肿物最大径分别为2.5 cm和1.5 cm,例1皮表呈红色,例2皮肤色泽正常。镜下肿瘤细胞位于皮下及真皮内,浸润性生长;细胞蓝染、圆形、大小均匀一致、松散、胞质较少,核仁不易见,细胞核空泡状,核分裂多见;免疫组化:2例瘤细胞CK20、Syn、AE1/AE3阳性。治疗及随访:例1行单纯肿物切除,术后10个月出现局部复发并广泛转移,2 m后死亡。例2确诊后行肿物扩大切除,随访8 m无局部复发及转移。结论:Merkel细胞癌是罕见皮肤神经内分泌肿瘤,恶性程度高,预后差。

Objective:To study the clinicopathological features of Merkel cell carcinoma of the face.Methods:The clinicopathological features and immunohistochemical results of 2 patients with facial Merkel cell carcinoma were observed.The clinical features were analyzed and the literature was reviewed.Results:Both female cases accidentally found hard facial mass,which gradually grew with the maximum diameter 2.5 cm and 1.5 cm,respectively.The skin surface of case 1 was red,and normal in case 2.Microscopically,the tumor cells were located in the subcutaneous and dermis and grew infiltratively.The cells were blue stain,round,uniform in size,loose,less cytoplasm,nucleoli were not easy to see,the nuclei were vacuolar and mitosis was common.Immunohistochemistry showed positive CK20,SYN and AE1/AE3 in 2 tumor cells.Treatment and follow-up:Case 1 received simple resection of the tumor,and local recurrence and extensive metastasis occurred 10 months after surgery,and he died 2 months later.Case 2 underwent extensive resection of the tumor after diagnosis,and no local recurrence or metastasis was found in the 8-month followup.Conclusion:Merkel cell carcinoma is a rare cutaneous neuroendocrine tumor with high malignancy and poor prognosis.