BACKGROUND Patients with chronic inflammatory disorders are at a higher risk of developing aggressive Merkel cell carcinoma(MCC). Diabetes is a common chronic inflammatory disease that is possibly associated with MCC;...BACKGROUND Patients with chronic inflammatory disorders are at a higher risk of developing aggressive Merkel cell carcinoma(MCC). Diabetes is a common chronic inflammatory disease that is possibly associated with MCC;however, there are still no reports on the association between hepatitis B virus(HBV) infection and MCC. Whether there is an association between these three diseases and the specific mechanisms behind their effects is worth further research in the future.CASE SUMMARY We herein report a rare case of MCC with extracutaneous and nodal invasion in an Asian individual with type 2 diabetes mellitus and chronic HBV infection, but no immunosuppression or other malignancies. Such cases are uncommon and have rarely been reported in the literature. A 56-year-old Asian male presented with a significant mass on his right cheek and underwent extensive resection combined with parotidectomy, neck lymphadenectomy, and split-thickness skin grafting. Based on the histopathological findings, a diagnosis of MCC involving the adipose tissue, muscle, nerve, and parotid gland with lymphovascular invasion was made. Subsequently, he received radiotherapy with no adverse reactions.CONCLUSION MCC is a rare, aggressive skin cancer with frequent local recurrence, nodal invasion, and metastasis, which usually arises in older people of the white race. Patients with chronic inflammatory disorders are at a higher risk of developing aggressive MCC. The diagnosis can be confirmed with histology and immunohistochemistry. For localized MCC, surgery is the preferred treatment option. However, for advanced MCC, radiotherapy and chemotherapy have proven to be effective. In cases where chemotherapy is not effective or in the advanced stages of MCC, immune therapy plays an important role in treatment. As with any rare disease, the management of MCC remains an enormous challenge for clinicians;thus, follow-up should be individualized and future progress needs multidisciplinary collaborative efforts. Furthermore, physicians should include MCC in their list of possible diagnoses when they come across painless, rapidly growing lesions, particularly in patients with chronic HBV infection or diabetes, as these patients are more susceptible to the development of this condition and it tends to be more aggressive in them.展开更多
BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive cutaneous neuroendocrine neoplasia,with high risk of recurrence and metastasis and poor survival.Immune checkpoint inhibitors,like the anti-programmed deat...BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive cutaneous neuroendocrine neoplasia,with high risk of recurrence and metastasis and poor survival.Immune checkpoint inhibitors,like the anti-programmed death-ligand 1 agent avelumab,were recently approved for the treatment of advanced MCC.We,herein,report the first case of advanced MCC with oligoprogression managed with avelumab and local radical treatment.CASE SUMMARY A 61-year-old man was presented to the hospital with sporadic fever and an exudative malodorous mass(10 cm of diameter),located on the right gluteal region.The final diagnosis was MCC,cT4N3M1c(AJCC,TNM staging 8th edition,2017),with invasion of adjacent muscle,in-transit metastasis,and bone lesions.Patient started chemotherapy(cisplatin and etoposide),and after six cycles,the main tumor increased,evidencing disease progression.Two months later,the patient started second line treatment with avelumab(under an early access program).After two cycles of treatment,the lesion started to decrease,achieving a major response.Local progression was documented after 16 cycles.However,as the tumor became resectable,salvage surgery was performed,while keeping the systemic treatment with avelumab.Since the patient developed bilateral pneumonia,immunotherapy was suspended.More than 2.5 years after surgery(last 19 mo without systemic therapy),the patient maintains complete local response and stable bone lesions.CONCLUSION This report highlights the efficacy and long-term response of avelumab on the management of a chemotherapy resistant advanced MCC,with evidence of oligoprogression,in combination with local radical treatment.展开更多
Metastatic Merkel Cell carcinoma (MCC) is a highly unusual and aggressive skin cancer that presents as a small, pink to violet skin lesion and metastasizes early in its growth. Metastatic MCC is generally treated with...Metastatic Merkel Cell carcinoma (MCC) is a highly unusual and aggressive skin cancer that presents as a small, pink to violet skin lesion and metastasizes early in its growth. Metastatic MCC is generally treated with small cell lung cancer chemotherapy regimens, because the tumor consists of neuroendocrine cells, but patients generally do not have durable responses. The pathogenesis of MCC has recently been attributed to the Merkel Cell polyoma virus. This virus activates the cellular retinoblastoma oncoprotein and cell cycle machinery, triggering continual cellular proliferation. A 77-year-old man developed extensive MCC metastases, involving more than one fourth of his scalp and numerous cervical lymph nodes. Following failure of initial chemotherapy and radiation, effective palliation was achieved by using a sequence of electron-beam radiotherapy, low dose gemcitabine, and etoposide, resulting in significant periods of tumor regression and prolonged survival. A novel circulating tumor cell (CTC) culture assay was performed on four separate clinic visits during the treatment period. Tumor colonies were cultured from the patient’s peripheral blood and CTC colony counts were correlated with clinical treatment response. Not only did the patient respond to palliative cell cycle directed chemotherapy and electron beam radiation, but we demonstrated that CTC can be cultured from peripheral blood of MCC patients and serve as a predictive marker to monitor treatment response.展开更多
The purpose of this paper is to report a case of rare localised (limited to eyelid) malignant eyelid tumor in a 70 year old Indian male. Histopathology confirmed it to be a Merkel cell carcinoma. Surgical excision and...The purpose of this paper is to report a case of rare localised (limited to eyelid) malignant eyelid tumor in a 70 year old Indian male. Histopathology confirmed it to be a Merkel cell carcinoma. Surgical excision and eyelid reconstruction was done successfully. No local or systemic recurrence has been noted at a follow up of 2 years. The well defined nature of a highly malignant tumor, its localised presentation and management is being described in following report.展开更多
Introduction:Merkel cell carcinoma(MCC)is a rare,aggressive cutaneous malignancy,and its pathogenesis might relate to ultraviolet light and Merkel cell polyomavirus infection.MCC in the Chinese population is uncommon....Introduction:Merkel cell carcinoma(MCC)is a rare,aggressive cutaneous malignancy,and its pathogenesis might relate to ultraviolet light and Merkel cell polyomavirus infection.MCC in the Chinese population is uncommon.Here,we present a case of MCC that occurred based on widespread actinic keratosis(AK)in a Chinese female.Case report:An 82-year-old woman presented with two rapidly enlarging and rupture lesions on the face for 1 year.Biopsy was suggestive of squamous cell carcinoma(SCC)on the forehead and MCC on the left cheek.The patient had a history of generalized AK for 3 years.The lesion on the left cheek was also revealed as an AK by histopathological examination 1 year ago.Complete surgical resection was performed to remove the two malignancies.Discussion:The co-occurrence of AK,SCC,and MCC in a Chinese woman is unusual.Immunohistopathological examination is vital for correct diagnosis.The three tumors,in this case,may originate from two different precursor cells and are affected by the same carcinogen.Alternatively,they may come from the same pluripotent epidermal stem cells,and chronic exposure to ultraviolet light and Merkel cell polyomavirus lead to the formation of different types of tumors.The coexist of MCC with other cutaneous tumors provided a train of thought for exploring the origin of MCC.Conclusion:We reported a rare co-existence phenomenon of MCC associated with AK and SCC.Hence,long-term follow-up and early treatment are imperative for patients with premalignant lesions,such as widespread AK.展开更多
Merkel cell carcinoma(MCC),first described in 1972,is an aggressive primary cutaneous carcinoma able to incorporate both epithelial and neuroendocrine features.MCC mainly appears in individuals in their eighth decade ...Merkel cell carcinoma(MCC),first described in 1972,is an aggressive primary cutaneous carcinoma able to incorporate both epithelial and neuroendocrine features.MCC mainly appears in individuals in their eighth decade and it is related to a high mortality rate.The etiology of this rare disease is not well-understood but ultraviolet radiation exposure,immune suppression,and aging have a consistent role in its pathogenesis.Usually,clinical lesions appear as asymptomatic coloured dermal nodules.The tumour can involve lymph nodes but further evaluation with imaging is recommended.The common approach for localized disease is surgical.This work reports a case of an 86-year-old man with locally advanced MCC where,based on clinical experience,oral mono-chemotherapy with single-agent etoposide was chosen as first-line therapy.A complete objective response was achieved in 2 months.展开更多
Merkel cell carcinoma (MCC) is an uncommon,potentially lethal and cutaneous tumor that mainly occurson the sun-exposed skin of the head and neck area in theelderly. It is 100 times less observed than melanoma. Weprese...Merkel cell carcinoma (MCC) is an uncommon,potentially lethal and cutaneous tumor that mainly occurson the sun-exposed skin of the head and neck area in theelderly. It is 100 times less observed than melanoma. Wepresent here a case report of recurrent MCC in a Chineseman.展开更多
基金Supported by The Young Talent Project of Zhejiang Medicine and Health Science and Technology Project,No.2022KY049 and No.2022RC097Zhejiang Province Public Welfare Technology Research Project,No.LGF20H110003.
文摘BACKGROUND Patients with chronic inflammatory disorders are at a higher risk of developing aggressive Merkel cell carcinoma(MCC). Diabetes is a common chronic inflammatory disease that is possibly associated with MCC;however, there are still no reports on the association between hepatitis B virus(HBV) infection and MCC. Whether there is an association between these three diseases and the specific mechanisms behind their effects is worth further research in the future.CASE SUMMARY We herein report a rare case of MCC with extracutaneous and nodal invasion in an Asian individual with type 2 diabetes mellitus and chronic HBV infection, but no immunosuppression or other malignancies. Such cases are uncommon and have rarely been reported in the literature. A 56-year-old Asian male presented with a significant mass on his right cheek and underwent extensive resection combined with parotidectomy, neck lymphadenectomy, and split-thickness skin grafting. Based on the histopathological findings, a diagnosis of MCC involving the adipose tissue, muscle, nerve, and parotid gland with lymphovascular invasion was made. Subsequently, he received radiotherapy with no adverse reactions.CONCLUSION MCC is a rare, aggressive skin cancer with frequent local recurrence, nodal invasion, and metastasis, which usually arises in older people of the white race. Patients with chronic inflammatory disorders are at a higher risk of developing aggressive MCC. The diagnosis can be confirmed with histology and immunohistochemistry. For localized MCC, surgery is the preferred treatment option. However, for advanced MCC, radiotherapy and chemotherapy have proven to be effective. In cases where chemotherapy is not effective or in the advanced stages of MCC, immune therapy plays an important role in treatment. As with any rare disease, the management of MCC remains an enormous challenge for clinicians;thus, follow-up should be individualized and future progress needs multidisciplinary collaborative efforts. Furthermore, physicians should include MCC in their list of possible diagnoses when they come across painless, rapidly growing lesions, particularly in patients with chronic HBV infection or diabetes, as these patients are more susceptible to the development of this condition and it tends to be more aggressive in them.
文摘BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive cutaneous neuroendocrine neoplasia,with high risk of recurrence and metastasis and poor survival.Immune checkpoint inhibitors,like the anti-programmed death-ligand 1 agent avelumab,were recently approved for the treatment of advanced MCC.We,herein,report the first case of advanced MCC with oligoprogression managed with avelumab and local radical treatment.CASE SUMMARY A 61-year-old man was presented to the hospital with sporadic fever and an exudative malodorous mass(10 cm of diameter),located on the right gluteal region.The final diagnosis was MCC,cT4N3M1c(AJCC,TNM staging 8th edition,2017),with invasion of adjacent muscle,in-transit metastasis,and bone lesions.Patient started chemotherapy(cisplatin and etoposide),and after six cycles,the main tumor increased,evidencing disease progression.Two months later,the patient started second line treatment with avelumab(under an early access program).After two cycles of treatment,the lesion started to decrease,achieving a major response.Local progression was documented after 16 cycles.However,as the tumor became resectable,salvage surgery was performed,while keeping the systemic treatment with avelumab.Since the patient developed bilateral pneumonia,immunotherapy was suspended.More than 2.5 years after surgery(last 19 mo without systemic therapy),the patient maintains complete local response and stable bone lesions.CONCLUSION This report highlights the efficacy and long-term response of avelumab on the management of a chemotherapy resistant advanced MCC,with evidence of oligoprogression,in combination with local radical treatment.
文摘Metastatic Merkel Cell carcinoma (MCC) is a highly unusual and aggressive skin cancer that presents as a small, pink to violet skin lesion and metastasizes early in its growth. Metastatic MCC is generally treated with small cell lung cancer chemotherapy regimens, because the tumor consists of neuroendocrine cells, but patients generally do not have durable responses. The pathogenesis of MCC has recently been attributed to the Merkel Cell polyoma virus. This virus activates the cellular retinoblastoma oncoprotein and cell cycle machinery, triggering continual cellular proliferation. A 77-year-old man developed extensive MCC metastases, involving more than one fourth of his scalp and numerous cervical lymph nodes. Following failure of initial chemotherapy and radiation, effective palliation was achieved by using a sequence of electron-beam radiotherapy, low dose gemcitabine, and etoposide, resulting in significant periods of tumor regression and prolonged survival. A novel circulating tumor cell (CTC) culture assay was performed on four separate clinic visits during the treatment period. Tumor colonies were cultured from the patient’s peripheral blood and CTC colony counts were correlated with clinical treatment response. Not only did the patient respond to palliative cell cycle directed chemotherapy and electron beam radiation, but we demonstrated that CTC can be cultured from peripheral blood of MCC patients and serve as a predictive marker to monitor treatment response.
文摘The purpose of this paper is to report a case of rare localised (limited to eyelid) malignant eyelid tumor in a 70 year old Indian male. Histopathology confirmed it to be a Merkel cell carcinoma. Surgical excision and eyelid reconstruction was done successfully. No local or systemic recurrence has been noted at a follow up of 2 years. The well defined nature of a highly malignant tumor, its localised presentation and management is being described in following report.
文摘Introduction:Merkel cell carcinoma(MCC)is a rare,aggressive cutaneous malignancy,and its pathogenesis might relate to ultraviolet light and Merkel cell polyomavirus infection.MCC in the Chinese population is uncommon.Here,we present a case of MCC that occurred based on widespread actinic keratosis(AK)in a Chinese female.Case report:An 82-year-old woman presented with two rapidly enlarging and rupture lesions on the face for 1 year.Biopsy was suggestive of squamous cell carcinoma(SCC)on the forehead and MCC on the left cheek.The patient had a history of generalized AK for 3 years.The lesion on the left cheek was also revealed as an AK by histopathological examination 1 year ago.Complete surgical resection was performed to remove the two malignancies.Discussion:The co-occurrence of AK,SCC,and MCC in a Chinese woman is unusual.Immunohistopathological examination is vital for correct diagnosis.The three tumors,in this case,may originate from two different precursor cells and are affected by the same carcinogen.Alternatively,they may come from the same pluripotent epidermal stem cells,and chronic exposure to ultraviolet light and Merkel cell polyomavirus lead to the formation of different types of tumors.The coexist of MCC with other cutaneous tumors provided a train of thought for exploring the origin of MCC.Conclusion:We reported a rare co-existence phenomenon of MCC associated with AK and SCC.Hence,long-term follow-up and early treatment are imperative for patients with premalignant lesions,such as widespread AK.
文摘Merkel cell carcinoma(MCC),first described in 1972,is an aggressive primary cutaneous carcinoma able to incorporate both epithelial and neuroendocrine features.MCC mainly appears in individuals in their eighth decade and it is related to a high mortality rate.The etiology of this rare disease is not well-understood but ultraviolet radiation exposure,immune suppression,and aging have a consistent role in its pathogenesis.Usually,clinical lesions appear as asymptomatic coloured dermal nodules.The tumour can involve lymph nodes but further evaluation with imaging is recommended.The common approach for localized disease is surgical.This work reports a case of an 86-year-old man with locally advanced MCC where,based on clinical experience,oral mono-chemotherapy with single-agent etoposide was chosen as first-line therapy.A complete objective response was achieved in 2 months.
文摘Merkel cell carcinoma (MCC) is an uncommon,potentially lethal and cutaneous tumor that mainly occurson the sun-exposed skin of the head and neck area in theelderly. It is 100 times less observed than melanoma. Wepresent here a case report of recurrent MCC in a Chineseman.
