Merkel cell carcinoma with divergent differentiation: two case reports.

08:00 EDT 3rd October 2019 | BioPortfolio

Summary of "Merkel cell carcinoma with divergent differentiation: two case reports."

Merkel cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin, usually occurring at sun-exposed sites in the elderly. Divergent differentiation in MCC, though rare, has been reported in previous case series. We describe two new cases of MCC with divergent differentiation. Case 1 was a 96 year-old male with a scalp lesion; on biopsy, the morphology and immunoprofile suggested MCC with divergent squamous differentiation. Case 2 was an 87 year-old female, with a lesion on the leg, originally reported as squamous cell carcinoma, later showing extensive local recurrence. On review, primary histology showed a Merkel cell carcinoma with divergent differentiation, most likely trichilemmal carcinoma; the recurrence showed only MCC. These cases illustrate that Merkel cell carcinoma is capable of divergent differentiation, including squamous and adnexal morphologies. Correct diagnosis is essential for appropriate prognosis and management, as later recurrence or metastases may only show the Merkel-cell component.


Journal Details

This article was published in the following journal.

Name: Clinical and experimental dermatology
ISSN: 1365-2230


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Medical and Biotech [MESH] Definitions

A carcinoma arising from MERKEL CELLS located in the basal layer of the epidermis and occurring most commonly as a primary neuroendocrine carcinoma of the skin. Merkel cells are tactile cells of neuroectodermal origin and histologically show neurosecretory granules. The skin of the head and neck are a common site of Merkel cell carcinoma, occurring generally in elderly patients. (Holland et al., Cancer Medicine, 3d ed, p1245)

A species of POLYOMAVIRUS suspected to be the cause of most cases of MERKEL CELL CARCINOMA, a rare but highly lethal form of skin cancer.

A group of carcinomas which share a characteristic morphology, often being composed of clusters and trabecular sheets of round "blue cells", granular chromatin, and an attenuated rim of poorly demarcated cytoplasm. Neuroendocrine tumors include carcinoids, small ("oat") cell carcinomas, medullary carcinoma of the thyroid, Merkel cell tumor, cutaneous neuroendocrine carcinoma, pancreatic islet cell tumors, and pheochromocytoma. Neurosecretory granules are found within the tumor cells. (Segen, Dictionary of Modern Medicine, 1992)

Modified epidermal cells located in the stratum basale. They are found mostly in areas where sensory perception is acute, such as the fingertips. Merkel cells are closely associated with an expanded terminal bulb of an afferent myelinated nerve fiber. Do not confuse with Merkel's corpuscle which is a combination of a neuron and an epidermal cell.

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