Merkel cell carcinoma with lymph node metastasis in the absence of a primary site: Case report and literature review

Zhao,Min; Meng,Mao-Bin

doi:10.3892/ol.2012.922

Merkel cell carcinoma with lymph node metastasis in the absence of a primary site: Case report and literature review

Authors:
- Min Zhao
- Mao-Bin Meng
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Affiliations: Tianjin University of Traditional Chinese Medicine, Tianjin, P.R. China, Department of Radiation Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Hospital and Institute, Tianjin 300060, P.R. China
Published online on: September 19, 2012 https://doi.org/10.3892/ol.2012.922
Pages: 1329-1334

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Abstract

Merkel cell carcinoma (MCC) is a rare malignant skin neoplasm with the potential for local recurrence, spreading to regional lymph nodes (LNs) and distant metastases. Although it has been identified in various anatomical sites, LN metastatic MCC in the absence of a primary site is extremely rare. The present case reports a 54-year-old male who initially underwent histological examination of a biopsy specimen from the right inguinal LNs. A diagnosis of metastatic small cell carcinoma was made. Nine months later, this diagnosis was changed to MCC with multiple metastases following observation of a tumour mass in the right dorsal thigh. Additionally, in the present study a summary is provided of 23 published cases of MCC with initial LN metastasis in the absence of a primary site, with details of clinical characteristics, natural history and pertinent therapy of this uncommon tumour. The present patient with LN metastatic MCC in the absence of a primary site and the other reported cases demonstrate that although multimodal treatment with surgery, radiotherapy (RT) and chemotherapy provides excellent local control, local recurrence and distant metastases commonly develop in this uncommon tumour. LN metastatic MCC in the absence of a primary site is a highly malignant disease and the role of adjuvant postoperative RT and/or chemotherapy remains to be fully determined.

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