title: Complete Spontaneous Regression of Merkel Cell Carcinoma After Biopsy: A Case Report and Review of the Literature.
abstract: Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumor that typically occurs on the head and neck of the elderly and follows an aggressive clinical course. Merkel cell polyomavirus (MCPyV) has been identified in up to 80% of cases and has been shown to participate in MCC tumorigenesis. Complete spontaneous regression of MCC has been rarely reported in the literature. We describe a case of a 79-year-old man that presented with a rapidly growing, 3-cm mass on the left jaw. An incisional biopsy revealed MCC. Additional health issues were discovered in the preoperative workup of this patient which delayed treatment. One month after the biopsy, the lesion showed clinical regression in the absence of treatment. Wide excision of the biopsy site with sentinel lymph node dissection revealed no evidence of MCC 2 months later. The tumor cells in the patient's biopsy specimen were negative for MCPyV by polymerase chain reaction and immunohistochemistry (CM2B4 antibody, Santa Cruz, CA). The exact mechanism for complete spontaneous regression in MCC is unknown. To our knowledge, only 2 previous studies evaluated the presence of MCPyV by polymerase chain reaction in MCC with spontaneous regression. Whether the presence or absence of MCPyV correlates with spontaneous regression warrants further investigation.
authors.affiliation: Department of Pathology, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Parnian
authors.initials: P
authors.lastname: Ahmadi Moghaddam
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Cornejo
authors.forename: Lloyd
authors.initials: L
authors.lastname: Hutchinson
authors.forename: Keith
authors.initials: K
authors.lastname: Tomaszewicz
authors.forename: Karen
authors.initials: K
authors.lastname: Dresser
authors.forename: April
authors.initials: A
authors.lastname: Deng
authors.forename: Patrick
authors.initials: P
authors.lastname: OʼDonnell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D015266:Carcinoma, Merkel Cell / Q000737:chemistry / Q000473:pathology* / Q000821:virology; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D007568:Jaw; D008297:Male; D059965:Merkel cell polyomavirus / Q000235:genetics / Q000276:immunology; D008875:Middle Aged; D009365:Neoplasm Regression, Spontaneous; D016133:Polymerase Chain Reaction; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000821:virology; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D004279:DNA, Viral