Clinical emergence of neurometastatic merkel cell carcinoma: a surgical case series and literature review

Bailey, Thomasina L.; Fung, Maxwell A.; Gandour‐Edwards, Regina; Ellis, William G.; Schrot, Rudolph J.

doi:10.1007/s11060-010-0304-8

Cited by 10 publications

(7 citation statements)

References 39 publications

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“…The survival rate after the CNS diagnosis is 73% at 6 months and 33% at 1 year. This is consistent with the previous report of a median survival time of 8.5 months after a diagnosis of Merkel cell CNS metastasis ( 4 ). None of the reported cases described prior immunosuppression before MCC was detected.…”

Section: Introductionsupporting

confidence: 93%

Merkel Cell Carcinoma with Distant Metastasis to the Clivus Causing Symptoms Mimicking Tolosa–Hunt Syndrome: A Case Report and Literature Review

Drew

Chuquilin

2017

Front. Neurol.

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Merkel cell carcinoma (MCC) is an uncommon but highly malignant neuroendocrine tumor of the skin. MCC can metastasize, but involvement of the central nervous system is rare. Here, we report a case of rapidly progressing metastatic MCC to the clivus and bilateral cavernous sinus in an immunocompromised patient. This case is unique in that it is the first case report showing MCC metastasis to the clivus from a distant site. It also demonstrates that a MCC metastasis can masquerade with symptoms of Tolosa–Hunt syndrome. A literature review on MCC with CNS metastasis is presented.

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Section: Introductionsupporting

confidence: 93%

Merkel Cell Carcinoma with Distant Metastasis to the Clivus Causing Symptoms Mimicking Tolosa–Hunt Syndrome: A Case Report and Literature Review

Drew

Chuquilin

2017

Front. Neurol.

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“…20% in stage IV patients, is much higher than expected from previous observations that reported central nervous system involvement to be a very rare event in MCC. Thus, SSTR-PET appears as a highly sensitive means to detect cerebral metastases of MCC that may have been under-diagnosed previously [ 29 ] and SSTR-PET is superior to FDG-PET in this regard [ 14 ]. SSTR-PET was superior to CT regarding detection of soft tissue metastases which could also have further impact on the therapeutic decision making process.…”

Section: Discussionmentioning

confidence: 99%

Somatostatin receptor expression in Merkel cell carcinoma as target for molecular imaging

et al. 2014

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BackgroundMerkel cell carcinoma (MCC) is a rare cutaneous neoplasm with increasing incidence, aggressive behavior and poor prognosis. Somatostatin receptors (SSTR) are expressed in MCC and represent a potential target for both imaging and treatment.MethodsTo non-invasively assess SSTR expression in MCC using PET and the radiotracers [68Ga]DOTA-D-Phe1-Tyr3-octreotide (DOTATOC) or -octreotate (DOTATATE) as surrogate for tumor burden. In 24 patients with histologically proven MCC SSTR-PET was performed and compared to results of computed tomography (CT).ResultsSSTR-PET detected primary and metastatic MCC lesions. On a patient-based analysis, sensitivity of SSTR-PET was 73% for nodal metastases, 100% for bone, and 67% for soft-tissue metastases, respectively. Notably, brain metastases were initially detected by SSTR-PET in 2 patients, whereas liver and lung metastases were diagnosed exclusively by CT. SSTR-PET showed concordance to CT results in 20 out of 24 patients. Four patients (17%) were up-staged due to SSTR-PET and patient management was changed in 3 patients (13%).ConclusionSSTR-PET showed high sensitivity for imaging bone, soft tissue and brain metastases, and particularly in combination with CT had a significant impact on clinical stage and patient management.

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“…MCC rarely involves the brain, with only 33 such reported cases as at 2011 [104]. In addition, prophylactic cranial irradiation can result in cognitive impairment so it is not recommended as standard of care in MCC.…”

Section: Referral For Other Treatmentsmentioning

confidence: 99%

A Practical Update of Surgical Management of Merkel Cell Carcinoma of the Skin

Tai¹

2013

ISRN Surgery

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The role of surgeons in the treatment of Merkel cell carcinoma (MCC) of the skin is reviewed, with respect to diagnosis and treatment. Most of the data in the literature are case reports. Surgery is the mainstay of treatment. A wide local excision, with sentinel node (SLN) biopsy, is the recommended treatment of choice. If SLN is involved, nodal dissection should be performed; unless patient is unfit, then regional radiotherapy can be given. Surgeons should always refer patients for assessment of the need for adjuvant treatments. Adjuvant radiotherapy is well tolerated and effective to minimize recurrence. Adjuvant chemotherapy may be considered for selected node-positive patients, as per National Comprehensive Cancer Network guideline. Data are insufficient to assess whether adjuvant chemotherapy improves survival. Recurrent disease should be treated by complete surgical resection if possible, followed by radiotherapy and possibly chemotherapy. Generally results of multimodality treatment for recurrent disease are better than lesser treatments. Future research should focus on newer chemotherapy and molecular targeted agents in the adjuvant setting and for gross disease.

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Clinical emergence of neurometastatic merkel cell carcinoma: a surgical case series and literature review

Cited by 10 publications

References 39 publications

Merkel Cell Carcinoma with Distant Metastasis to the Clivus Causing Symptoms Mimicking Tolosa–Hunt Syndrome: A Case Report and Literature Review

Merkel Cell Carcinoma with Distant Metastasis to the Clivus Causing Symptoms Mimicking Tolosa–Hunt Syndrome: A Case Report and Literature Review

Somatostatin receptor expression in Merkel cell carcinoma as target for molecular imaging

A Practical Update of Surgical Management of Merkel Cell Carcinoma of the Skin

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