Treatment of a Patient with Merkel Cell Skin Carcinoma Using Radiation Therapy - A Case Report

Petrov, Andrej and Kraleva, Slavica and Kubelka-Sabit, Katerina and Petrova, Deva (2018) Treatment of a Patient with Merkel Cell Skin Carcinoma Using Radiation Therapy - A Case Report. Open Access Maced J Med Sci . ISSN eISSN: 1857-9655

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Abstract

BACKGROUND: Merkel cell carcinoma (MCC) is a rare, very aggressive tumour. The pathogenesis remains
unclear, but UV radiation, immunosuppression, and the presence of Merkel cell polyomavirus in the tumour
genome appear to have a key role. Merkel cell carcinoma is a highly aggressive tumour that often has a lethal
end.
CAS REPORT: A patient at 93 years of age comes for an examination by a dermatologist due to a rapidly
growing nodular tumour growth in the forehead area. A tumour was about 3 cm in size. It had no signs of basal-
cell carcinoma, no arborising vascularisation, no pigmentations on dermoscopy. Clinically, an eventual Merkel cell
carcinoma was considered for the patient, but other primary skin tumours had to be excluded, as well as the
possibility that regarding the patient’s age, it may be a metastatic deposit. A skin biopsy was performed, as well
as H-E examination and immunohistochemical analyses (positive CD56, positivity of neuroendocrine markers
synaptophysin, chromogranin) which were in favour of Merkel cell carcinoma of the skin. After setting the
diagnosis, our patient was treated with therapy which led to a complete withdrawal of a tumour. However, after 3
months the patient had repeated relapse of a tumour at the same site on the forehead and metastases in the
retroauricular lymph nodes bilaterally. It shows that the radiotherapy as monotherapy has a great effect on the
removal of the tumour formation, but unfortunately, it has no impact on lesion recurrence. It is also compatible
with the literature data.
CONCLUSION: In many adult patients, as our case suggests, radiotherapy could be a good palliative treatment
opportunity that should be considered, as well as a combination of radiation therapy with other oncologic
therapeutic options.

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Andrej Petrov
Date Deposited:	19 Apr 2018 14:34
Last Modified:	13 Jan 2023 10:58
URI:	https://eprints.ugd.edu.mk/id/eprint/19869

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