Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(01): 128-131
DOI: 10.4103/ajns.AJNS_5_18
Case Report

Spinal metastasis from merkel cell carcinoma in an elderly male

Kalah Jockisch
Department of Internal Medicine, Lincoln Memorial University-DeBusk College of Osteopathic Medicine, Harrogate, Tennessee
,
Yazan Abdeen
1   Department of Pulmonary, Mercy Hospital, Fort Smith, AR
,
Carlisle Alderink
2   Department of Pathology, Mercy Hospital, Fort Smith, AR
,
Tony Flippin
3   Department of Oncology, Mercy Hospital, Fort Smith, AR
,
Sugabramya Kuru
4   St. Michael's Medical Center, Newark, NJ
,
Hamid Shaaban
5   Department of Medical Oncology, St. Michaels Medical Center, Affiliate of New York Medical College, Newark, NJ
› Author Affiliations
› Further Information
Also available at
  Permissions and Reprints

Merkel cell carcinoma is a cutaneous neuroendocrine malignancy that has an aggressive nature. Classically, it affects the elderly Caucasian population with a predilection for the sun-exposed areas of the body. Pathogenesis has been linked to ultraviolet radiation, immunosuppression, and the Merkel cell polyomavirus. Definitive diagnosis entails histologic evaluation and immunohistochemical staining. With its generalized appearance and tendency for metastasis, a high index of suspicion must be utilized. In this case, we present the unique presentation of Merkel cell carcinoma as a rapidly enlarging lymph node with metastatic disease to the spinal column presenting as new-onset low back and radicular pain.

Key-words:

Elderly - merkel cell carcinoma - spinal metastasis

Financial support and sponsorship

Nil.




Publication History

Received: 11 January 2018

Accepted: 30 September 2019

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Heath M, Jaimes N, Lemos B, Mostaghimi A, Wang LC, Peñas PF, et al. Clinical characteristics of Merkel cell carcinoma at diagnosis in 195 patients: The AEIOU features. J Am Acad Dermatol 2008;58:375-81.
  • 2 Lemos B, Nghiem P. Merkel cell carcinoma: More deaths but still no pathway to blame. J Invest Dermatol 2007;127:2100-3.
  • 3 Lunder EJ, Stern RS. Merkel-cell carcinomas in patients treated with methoxsalen and ultraviolet A radiation. N Engl J Med 1998;339:1247-8.
  • 4 Bickle K, Glass LF, Messina JL, Fenske NA, Siegrist K. Merkel cell carcinoma: A clinical, histopathologic, and immunohistochemical review. Semin Cutan Med Surg 2004;23:46-53.
  • 5 NCCN Guidelines. Ver 1. Merkel Cell Carcinoma; 2017. Available from: http://www.nccn.org/professionals/physician_gls/pdf/mcc.pdf. [Last accessed on 2019 Oct 22].
  • 6 Ratner D, Nelson BR, Brown MD, Johnson TM. Merkel cell carcinoma. J Am Acad Dermatol 1993;29:143-56.
  • 7 Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE, et al. Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: A population based study. J Cutan Pathol 2010;37:20-7.
  • 8 Zhan FQ, Packianathan VS, Zeitouni NC. Merkel cell carcinoma: A review of current advances. J Natl Compr Canc Netw 2009;7:333-9.
  • 9 Sihto H, Kukko H, Koljonen V, Sankila R, Böhling T, Joensuu H. Clinical factors associated with Merkel cell polyomavirus infection in Merkel cell carcinoma. J Natl Cancer Inst 2009;101:938-45.
  • 10 Errichetti E, Piccirillo A, Ricciuti F, Ricciuti F. Pedunculated and telangiectatic Merkel cell carcinoma: An unusual clinical presentation. Indian J Dermatol 2013;58:243.
  • 11 Mamalis N, Medlock RD, Holds JB, Anderson RL, Crandall AS. Merkel cell tumor of the eyelid: A review and report of an unusual case. Ophthalmic Surg 1989;20:410-4.
  • 12 Goldenhersh MA, Prus D, Ron N, Rosenmann E. Merkel cell tumor masquerading as granulation tissue on a teenager's toe. Am J Dermatopathol 1992;14:560-3.
  • 13 Allen PJ, Bowne WB, Jaques DP, Brennan MF, Busam K, Coit DG, et al. Merkel cell carcinoma: Prognosis and treatment of patients from a single institution. J Clin Oncol 2005;23:2300-9.
  • 14 Chan JK, Suster S, Wenig BM, Tsang WY, Chan JB, Lau AL, et al. Cytokeratin 20 immunoreactivity distinguishes Merkel cell (primary cutaneous neuroendocrine) carcinomas and salivary gland small cell carcinomas from small cell carcinomas of various sites. Am J Surg Pathol 1997;21:226-34.
  • 15 Wang TS, Byrne PJ, Jacobs LK, Taube JM. Merkel cell carcinoma: Update and review. Semin Cutan Med Surg 2011;30:48-56.
  • 16 Warner TF, Uno H, Hafez GR, Burgess J, Bolles C, Lloyd RV, et al. Merkel cells and Merkel cell tumors. Ultrastructure, immunocytochemistry and review of the literature. Cancer 1983;52:238-45.
  • 17 Kassem A, Schöpflin A, Diaz C, Weyers W, Stickeler E, Werner M, et al. Frequent detection of Merkel cell polyomavirus in human Merkel cell carcinomas and identification of a unique deletion in the VP1 gene. Cancer Res 2008;68:5009-13.
  • 18 Penn I, First MR. Merkel's cell carcinoma in organ recipients: Report of 41 cases. Transplantation 1999;68:1717-21.
  • 19 Garneski KM, Nghiem P. Merkel cell carcinoma adjuvant therapy: Current data support radiation but not chemotherapy. J Am Acad Dermatol 2007;57:166-9.
  • 20 Tai P. A practical update of surgical management of Merkel cell carcinoma of the skin. ISRN Surg 2013;2013:850797.
  • 21 Siva S, Byrne K, Seel M, Bressel M, Jacobs D, Callahan J, et al. 18F-FDG PET provides high-impact and powerful prognostic stratification in the staging of Merkel cell carcinoma: A 15-year institutional experience. J Nucl Med 2013;54:1223-9.