A rare case of Merkel cell carcinoma presenting as a giant intra-thoracic mass

Abstract

Rationale:Merkel cell carcinoma (MCC) is an aggressive neuroendocrine-derived cutaneous cancer. Ectopic or single metastatic MCC located in thorax is extremely rare; meanwhile, its definite management has not been elucidated yet.Patient concerns:A 64-year-old female patient with a giant mass located in her left thorax was presented for stuffy pain of left chest for 6 months and fever for half a month. She underwent radical resection of vulvar MCC 10 years ago.Diagnoses:Computed tomography (CT)-guided biopsy of the intrathoracic mass revealed a diagnosis of MCC, without synchronous urogenital lesions on pelvic CT images.Interventions:This bulky tumor was completely resected via thoracotomy, along with the adjacent pulmonary lobe, pericardium, pleura, and diaphragm.Outcomes:The patient survived without local-regional recurrence or distant metastasis during the follow-up of 1 year up to now.Lessons:Ectopic or single metastatic MCC should be considered in the differential diagnosis of intrathoracic tumors, especially in patients with a history of MCC. Besides, a timely surgery combined with chemotherapy is effective for this disease.

A rare case of pleural localisation of both metastatic Merkel cell carcinoma and chronic lymphocytic leukaemia

“…Metastatic MCC has, of course, the worst prognosis, with 5‐year overall survival estimates of 14%‐25%, compared to 51%‐75% for localised disease 2,5 . Nevertheless, metastatic cases are extremely rare (6%‐8% of MCC), and fewer than 10 cases of pleural effusion containing MCC cells have been reported in the literature 6,7 . Cases reporting MCC pleural metastases associated with another neoplasia are even rarer, which can lead to diagnosis difficulty.…”