Korean J Dermatol.  2012 Feb;50(2):106-113.

A Clinicopathologic Study of Merkel Cell Carcinoma

Affiliations
  • 1Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. miumiu@amc.seoul.kr

Abstract

BACKGROUND
Merkel cell carcinoma is a rare neuroendocrine tumor that typically presents as indurated nodules in elderly patients. It has an aggressive behavior and thus, such incidence has been increasing.
OBJECTIVE
Our purpose was to analyze clinical and histological characteristics of Merkel cell carcinoma, and to obtain a better understanding of this rare malignancy.
METHODS
We conducted a clinicopathologic evaluation of 11 patients from our center during 21 year period (1989~2010). We investigated personal and clinical information, including age, sex, time of onset, past history, histologic findings and clinical manifestations.
RESULTS
The age of the 11 patients ranged from 48 to 84, and the mean age of onset was 62.3, with a slight female predominance (1:1.7). The most prevalent site was the face then followed by the extremities. Subcutaneous nodular lesion with overlying erythema was the most common finding (72.7%, 8/11). Protruding tumorous lesions were 18.2% (2/11) and palpable lymphadenopathy was 9.1% (1/11), respectively. Histopathologically, pleomorphic atypical cells and granular nuclear dots ("salt and pepper") were observed. Immunohistochemical study showed positivity for pan-cytokeratin (CK), cytokeratin (CK20), CD56, synaptophysin, chromogranin (90%, 81.8%, 100%, 85.7%, 83.3%) and negative result for leukocyte common antigen (LCA, 0/7), and thyroid transcription factor-1 (TTF-1, 0/4), S100 (0/4).
CONCLUSION
Merkel cell carcinomas were more frequent in old females and were rare in immunocompromised patients in Korea. Histologic and immunohistochemical features were similar to previous studies, but there was a case of rare type (CK7+/CK20-) of Merkel cell carcinoma. Surgery is a treatment of choice in Merkel cell carcinoma. But radiation or chemotherapy can be used as an adjuvant therapy. Based on this study, characteristics of Merkel cell carcinoma in Korea can be elucidated with more future cases.

Keyword

Merkel cell carcinoma; Neuroendocrine tumor

MeSH Terms

Age of Onset
Aged
Antigens, CD45
Carcinoma, Merkel Cell
Erythema
Extremities
Female
Humans
Immunocompromised Host
Incidence
Keratins
Korea
Lymphatic Diseases
Neuroendocrine Tumors
Synaptophysin
Thyroid Gland
Antigens, CD45
Keratins
Synaptophysin
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