title: Metastatic Merkel cell carcinoma in the bone marrow of a patient with plasma cell myeloma and therapy-related myelodysplastic syndrome.
abstract: Merkel cell carcinoma is an aggressive neoplasm of the skin that shows frequent lymph node metastases, but has only rarely been reported in the bone marrow. Herein we report a case of a 64-year-old male with a history of plasma cell myeloma and recent skin diagnosis of Merkel cell carcinoma who presented for a routine follow-up bone marrow to assess his myeloma. The biopsy showed persistent plasma cell myeloma, trilineage dysplasia, and clusters of neuroendocrine cells consistent with metastatic Merkel cell carcinoma. Discussion of this case, a review of metastatic Merkel cell carcinoma, and identification of clinical settings in which staging bone marrow biopsy may be warranted are presented.
authors.affiliation: Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232-5310, USA.
authors.forename: Megan Kielt
authors.initials: MK
authors.lastname: Kressin
authors.forename: Annette S
authors.initials: AS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D001856:Bone Marrow Examination; D019046:Bone Marrow Neoplasms / Q000737:chemistry / Q000235:genetics / Q000556:secondary* / Q000628:therapy; D015266:Carcinoma, Merkel Cell / Q000737:chemistry / Q000235:genetics / Q000556:secondary* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D009190:Myelodysplastic Syndromes / Q000209:etiology*; D016609:Neoplasms, Second Primary; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012878:Skin Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
keywords: Merkel cell; bone marrow metastases; plasma cell myeloma