title: Merkel cell carcinoma of unknown primary with lymph node and mesenteric metastasis involving the pancreas and duodenum.
abstract: Merkel cell carcinoma (MCC) of skin is a rare, aggressive cutaneous malignancy of neuroendocrine origin. MCC predominantly affects elderly Caucasians and has high predilection for sun exposed areas. Histologic exam and immunohistochemical profile is required to establish the diagnosis. It has high propensity for local recurrence and metastasis, and carries poor prognosis. However, metastasis to mesentery involving the duodenum is very uncommon and rarely reported in literature. We hereby describe a patient with lymph node and mesenteric metastasis invading duodenum and pancreas with unknown primary origin of MCC.
authors.affiliation: 1 Department of Internal Medicine, University of California, Riverside, School of Medicine, Riverside, California, USA ; 2 Department of Gastroenterology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA ; 3 Department of Adult Gastroenterology, Loma Linda University Medical Center, Loma Linda, California, USA ; 4 Department of Pathology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Yaramada
authors.affiliation: 1 Department of Internal Medicine, University of California, Riverside, School of Medicine, Riverside, California, USA ; 2 Department of Gastroenterology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA ; 3 Department of Adult Gastroenterology, Loma Linda University Medical Center, Loma Linda, California, USA ; 4 Department of Pathology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Lim
authors.affiliation: 1 Department of Internal Medicine, University of California, Riverside, School of Medicine, Riverside, California, USA ; 2 Department of Gastroenterology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA ; 3 Department of Adult Gastroenterology, Loma Linda University Medical Center, Loma Linda, California, USA ; 4 Department of Pathology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Flannery
authors.affiliation: 1 Department of Internal Medicine, University of California, Riverside, School of Medicine, Riverside, California, USA ; 2 Department of Gastroenterology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA ; 3 Department of Adult Gastroenterology, Loma Linda University Medical Center, Loma Linda, California, USA ; 4 Department of Pathology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Koh
authors.affiliation: 1 Department of Internal Medicine, University of California, Riverside, School of Medicine, Riverside, California, USA ; 2 Department of Gastroenterology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA ; 3 Department of Adult Gastroenterology, Loma Linda University Medical Center, Loma Linda, California, USA ; 4 Department of Pathology, Kaiser Permanente Riverside Medical Center, Riverside, California, USA.
authors.forename: Harout
authors.initials: H
authors.lastname: Yaghsezian
keywords: Merkel cell carcinoma (MCC); cytokeratin 20; immunohistochemical detection