Metastatic Merkel cell carcinoma of the oral cavity in a human immunodeficiency virus-positive patient and the detection of Merkel cell polyomavirus

Dec 2011

Li M, Saghafi N, Freymiller E, Basile JR, Lin YL.

Source

Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, California.

Abstract

The etiology of Merkel cell carcinoma (MCC) was recently linked to a newly identified human virus, the Merkel cellpolyomavirus (MCPyV). The discovery that MCPyV plays an important role in the tumorigenesis of >80% of MCCs provides an explanation for the increased incidence of this rare malignancy in human immunodeficiency virus (HIV)-positive and immunocompromised patients. We report an unusual metastasis of MCC to the mandibular gingiva of an HIV-positive patient. In addition to routine hematoxylin-eosin and immunohistochemical studies, we also performed a molecular biologic analysis to look for the presence of MCPyV in this case. We detected evidence of the MCPyV genome in this lesion similar to what has been observed for MCCs reported in other immunocompromised patients. These results stress the importance of combining morphologic and molecular biologic analyses in the evaluation of MCC, because confirmation of viral etiology would likely affect the choice of treatment and prognosis when specific antiviral therapy becomes available for this aggressive tumor

Science Direct.

Tumor-infiltrating lymphocytes and outcome in Merkel cell carcinoma, a virus-associated cancer.

Nov 2012 

Sihto H, Joensuu H.

Source

Laboratory of Molecular Oncology and Molecular Cancer Biology Program; University of Helsinki; Helsinki, Finland.

Abstract

Keywords: Merkel cell carcinoma, Merkel cell polyomavirus, cytotoxic T cells, survival, tumor-infiltrating lymphocytes

An intense immune infiltrate, enriched in T cells, is associated with the presence of Merkel cell polyomavirus (MCPyV) DNA in Merkel cell carcinoma (MCC), a rare skin cancer. High tumor-infiltrating T-cell counts are associated with favorable survival regardless of the tumor MCPyV status. Hence, boosting host immune functions might constitute a new approach for the treatment of MCC.

Full text article with images:

NCBI-NLM

Chronic lymphocytic leukemia, lymphoma, merkel cell carcinoma

Increased incidence of chronic lymphocytic leukaemia and lymphomas in patients with Merkel cell carcinoma - a population based study of 335 cases with neuroendocrine skin tumour.

Mar 2012

Tadmor T, Liphshitz I, Aviv A, Landgren O, Barchana M, Polliack A.

Source

Haematology, Oncology Unit, Bnai-Zion Medical Centre, Haifa, Israel.

Abstract

Merkel cell carcinoma (MCC) is a rare aggressive skin tumour that appears to be associated with a large number of other tumours. We collected all reported cases in Israel and estimated its association with other tumours, including haematological malignancies. The population based Israel Cancer Registry identified 335 patients with MCC diagnosed between1989 and 2010. Ninety-seven percent were in the Jewish population; median age at diagnosis for Jewish patients was 73·4 and 55·6 years for the Arab population. Other associated malignancies were encountered in 92 patients (27·4%) with MCC (90 Jews, two Arabs). Of the Jewish cases, 66 presented with an associated malignancy before, and 24 after, the diagnosis of MCC. Solid tumours were not significantly increased among patients with MCC. Thirty-one of these associated cancers (34·4%) were haemato-oncological malignancies, 24 were detected before and seven after the diagnosis of MCC. The standardized incidence ratio (SIR) for haematological malignancy was 3·67 for males and 3·62 for females, and the most frequent haemato-oncological neoplasias recorded were chronic lymphocytic leukaemia (45%) and lymphomas (29%). Although MCC is rare, clinicians should be aware of the possible association with B-cell lymphoproliferative disorders when evaluating patients with neuroendocrine skin tumours.

Wiley OnLine

Merkel cell carcinoma: histologic features and prognosis.

Merkel cell carcinoma: histologic features and prognosis.
Cancer. 2008 Nov

Andea AA, Coit DG, Amin B, Busam KJ.
Department of Pathology, Memorial Sloan- Kettering Cancer Center, New York, New York, USA. aandea@uab.edu

BACKGROUND: Currently, little is known regarding the potential prognostic value of histologic features in primary cutaneous neuroendocrine (Merkel cell) carcinomas (MCC).

METHODS: In a retrospective review of the tumor histology and clinical outcome data (median follow-up, 51 months; range, 3-224 months) of 156 patients with a diagnosis of MCC, the following histologic features were evaluated: tumor thickness, tumor size (greatest dimension of the tumor), microanatomic compartment involved by tumor (dermis and/or subcutis and/or deeper), tumor growth pattern (nodular circumscribed vs infiltrative), lymphovascular invasion (LVI), tumor-infiltrating lymphocytes, tumor necrosis, ulceration, and solar elastosis.

RESULTS: The overall 5-year survival rate was 67.5%. On univariate analysis, parameters that were associated significantly with survival were tumor thickness (P= .001), tumor size (P= .0002), deepest anatomic compartment involved by tumor (P= .0003), tumor growth pattern (P= .003), LVI (P< .00001), tumor-infiltrating lymphocytes (P= .05), and solar elastosis (P= .04). On multivariate analysis, the presence of a nodular growth pattern, low tumor depth, and absence of LVI were associated with longer survival.

CONCLUSIONS: In addition to the known prognostic value of tumor stage, 3 histologic features were identified to have prognostic significance: tumor thickness (depth of tumor invasion), the presence of LVI, and tumor growth pattern.

Wiley InterScience

Merkel cell carcinoma within follicular cysts: report of two cases.

Merkel cell carcinoma within follicular cysts: report of two cases.
Requena L, Jaqueti G, Rütten A, Mentzel T, Kutzner H.

Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.

Merkel cell carcinoma is a rare cutaneous neoplasm of unknown histogenesis. Several reports have described the association of Merkel cell carcinoma of the skin with other cutaneous neoplasms within the same lesion, and there are also reports describing three examples of Merkel cell carcinoma within follicular cysts. We describe two examples of Merkel cell carcinoma developed within epithelial cysts. Neoplastic cells of Merkel cell tumor expressed immunoreactivity for chromogranin, synaptophysin, neuron-specific enolase, CAM 5.2 and cytokeratin 20, the last two markers showing the characteristic paranuclear dot-like pattern. In contrast, the epithelial wall lining the cyst and surrounding Merkel cell tumor only expressed immunoreactivity for cytokeratin MNF116. The description of five cases of Merkel cell carcinoma within follicular cysts, including the two cases of this report, support some relationship between Merkel cell tumor and the hair follicle.

J Cutan Pathol. 2008 Dec

PMID: 18988316 [PubMed - in process]