A case of complete spontaneous regression of extremely advanced Merkel cell carcinoma

Abstract

Merkel cell carcinoma (MCC) is a rare locally malignant cutaneous tumor of neuroendocrine origin, most often occurring on the head and neck of the elderly. MCC is a highly aggressive tumor with a high percentage of recurrence, metastatic spread and mortality. Despite the highly malignant course of MCC, there have been several reports of spontaneous regression or resolution. We report the clinical course of a 71-year-old man with MCC. The tumor initially occurred in the left lower eyelid and advanced to encompass nearly half the face. Despite its large size, complete spontaneous regression of the tumor occurred. This is the most advanced case of complete spontaneous regression of MCC to be reported.

Complete spontaneous regression of Merkel cell carcinoma (1986–2016): a 30 year perspective

“…It seems likely that they are colluding factors in the generation of an anti‐tumoral immune response. Although many reports of CSR of MCC were published since 2008 none of them documented the viral status of the tumor . As part of the re‐examination of our case, (discussed above), we determined that the tumor was MCPyV positive …”

“…Since the seminal report by O' Rourke and Bell in 1986, less than 40 cases of regression of MCC have been published in the North American, Japanese and European literature . Mid‐way through the ensuing 30 years, Connelly and colleagues conducted a helpful review of the topic .…”

“…Finally, a remarkable case of regression of an advanced MCC which occupied more than half of the patient's face deserves mention . Beginning as a nodule on the left lower eyelid of a 71‐year‐old man, the tumor was treated with a standard aggressive approach including surgery, radiotherapy and chemotherapy.…”

Rationale For Immune-Based Therapies in Merkel Polyomavirus-Positive and -Negative Merkel Cell Carcinomas

“…Additionally, MCCs can regress following withdrawal of immune suppressive treatment [35,36] and spontaneous regression of MCCs is associated with T cell and foamy macrophage infiltration suggesting that regression may be immune-cell mediated [37,38]. While rare, spontaneous regression in MCC is much more common (1.3 per 1000 cases) than in other malignancies (1 in 60,000-100,000 cases) [38].…”

Carcinoma Avançado de Células de Merkel: Um Novo Caso de Regressão Espontânea

“…1 Spontaneous regression is a very rare occurrence in Merkel cell carcinoma with very few cases reported so far, none of them in Portugal. [2][3][4][5][6] CASE REPORT An 89-year-old woman, Fitzpatrick phototype III, farmer during 40 years andwith no relevant past medical history was observed with a rapidly-growing nodule (evolution of 3 months) with 3 cm in the left nasal ala. Histopathological examination of a skin biopsy specimen revealed a tumour composed by medium-sized cells with scant cytoplasm and hyperchromatic nucleus. Focal necrosis and frequent mitosis were also observed.…”