Giant metastatic Merkel cell carcinoma.
A 68-year-old man presented with a rapidly growing, asymptomatic mass on his left mid-back for the past 3 months. The patient's medical history revealed an intentional 60-pound weight loss over the previous 2 years along with smoking approximately 1 pack of cigarettes per day. On physical examination, a fungating, 11-cm red tumor with palpable broader underlying extension (23 cm total) was present on the left mid-back with distinct red dermal nodules in a dermatomal distribution. In close proximity were two ulcerated nodules, proven histologically to be basal cell carcinomas. In the left groin was massive, fixed lymphadenopathy. A punch biopsy of the tumor was performed, which showed a dense infiltrate of small, round hyperchromatic blue cells that stained positive for CD 56 and pancytokeratin in a perinuclear dot pattern. Tumor cells were negative for CK20, TTF, CK7, and LCA.
Department of Dermatology, Jefferson Medical College, Sewell, NJ, USA.
Rachel
R
Bognet
Christina
C
Thompson
Carmen
C
Campanelli
D000368:Aged; D001415:Back; D001706:Biopsy / Q000379:methods; D019002:CD56 Antigen / Q000032:analysis; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000473:pathology*; D015266:Carcinoma, Merkel Cell / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000473:pathology; D008297:Male; D009362:Neoplasm Metastasis; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology*; D013194:Staining and Labeling
D019002:CD56 Antigen