Merkel cell carcinoma, Bowen's disease and chronic occupational arsenic poisoning.
We diagnosed a unique case of Merkel cell carcinoma (MCC) coexisting with Bowen's disease on the sole of the foot of a 72-year-old man who had worked for about 4 years in a factory handling inorganic arsenic. He had a past history of arsenical keratosis and multiple Bowen's disease. The tumour first appeared as a reddish macule and then showed marked growth over the next month. The tumour was excised and the specimen was examined histopathologically. The tumour consisted of two components: a group of atypical cells representing Bowen's disease in the epidermis and another group of atypical cells with a trabecular pattern characteristic of MCC in the dermis. Neither group of cells showed transitional findings, and the tumour elements were divided by a clear basement membrane. The tumour cells in the dermis were positive for neurone-specific enolase, and on electron microscopy had dense core granules in the cytoplasm. Inorganic arsenic can cause various cutaneous neoplasms, but to our knowledge, this is the first report of a case of MCC associated with Bowen's disease.
Tsuruta
D
D
Department of Dermatology, Osaka City University Medical School, 1-5-7 Asahimachi, Abeno-ku, Osaka 545, Japan.
Hamada
T
T
Mochida
K
K
Nakagawa
K
K
Kobayashi
H
H
Ishii
M
M
D000368:Aged; D020261:Arsenic Poisoning; D001913:Bowen's Disease / Q000139:chemically induced*; D015266:Carcinoma, Merkel Cell / Q000139:chemically induced*; D005534:Foot Diseases / Q000139:chemically induced*; D006801:Humans; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000139:chemically induced*; D009784:Occupational Diseases / Q000139:chemically induced*; D012878:Skin Neoplasms / Q000139:chemically induced*