Multiple Merkel cell carcinomas: Late metastasis or multiple primary tumors? A molecular study

Eluri, Madhulika; Feneran, Ashley; Bordeaux, Jeremy S.; Ruben, Beth S.; Ostrowski, Stephen M.; Bastian, Boris C.; Honda, Kord

doi:10.1016/j.jdcr.2017.01.011

Cited by 8 publications

(10 citation statements)

References 10 publications

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“…In human MCC, 27.7% of patients developed secondary lesions in the skin . Moreover, few case studies with genomic analyses have shown both possibilities: multicentric occurrence and distant skin metastasis . A previous study of human MCC showed that 22% of patients with recurrence developed distant metastasis .…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of Merkel cell carcinoma in 20 cats

Sumi¹,

Chambers

Doi³

et al. 2018

Vet Comparative Oncology

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The biological behaviour and prognostic factors of Merkel cell carcinoma (MCC) in 20 cats were studied. The tumours were surgically removed and histopathologically examined. The animals were 8 to 20 years old (median age: 14 years), and the tumours were predominantly located in the neck and head. Follow-up data were available in 17 cases, and 12 cats died within a year of surgery. The overall median survival time after resection was 243 days (range 16-360 days). Recurrence occurred in 11 cases, although 6 of them (55%) were found to be margin-negative. Possible metastasis occurred after the surgery in 10 cases, although 6 of them (60%) were found to be margin-negative. The histopathological features of MCC included tumour necrosis in 16 cases (80%), vascular invasion in 6 cases (38%) and high mitotic counts (median: 28.5 per high-power field). Irregular acanthosis was noted adjacent to the tumours in 9 cases (60%). Immunohistochemically, the tumour cells were positive for cytokeratin (CK) 20 and p63 in all cases, synaptophysin in 19 (95%) cases, and CK18 in 16 cases (80%). The study shows that feline MCC is associated with a poor prognosis and exhibited a strong tendency towards local recurrence, regional lymph node metastasis and distant spread.

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Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of Merkel cell carcinoma in 20 cats

Sumi¹,

Chambers

Doi³

et al. 2018

Vet Comparative Oncology

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“…2 MCC mostly occurs on sun-exposed skin, and the head and neck (53%) are the most affected parts of the body followed by the extremities (34-35%). 3 Besides advanced age, immunosuppression and UV-light exposure, MCPyV is considered a potential aetiological factor No evidence for regional lymph node metastasis, no evidence in distant metastasis; after 7 years, no evidence for regional lymph node metastasis, no evidence for distant metastasis for MCC. 4 Besides the viral capsid proteins (VP1,2,3), the genome of MCPyV encodes two tumour antigen oncoproteinscalled small T and large T antigen.…”

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confidence: 99%

“…4,6 MCPyV genomic analyses were used to distinguish between primary and recurrent or metastatic disease. 3,7,8 Similar aberrations in the molecular pattern would favour a metastasis, whereas different aberrations favour a second primary tumour. 8 Differentiation between two primary MCCs and metastatic disease is important with regard to the correct therapeutic approach.…”

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confidence: 99%

“…8 Differentiation between two primary MCCs and metastatic disease is important with regard to the correct therapeutic approach. 3 Patients diagnosed with MCC have a significantly increased risk of developing a second primary cancer, especially other sun-induced skin cancers. 5 Nevertheless, an increased risk of a second primary MCC has not been proven.…”

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confidence: 99%

“…1,2 The most common etiologic agent of Tinea cruris is Trichophyton rubrum. 3 Topical treatment options for Tinea cruris include azoles, terbinafine, butenafine and naftifine. 4 Dapaconazole tosylate is a new topical imidazole that has demonstrated to be effective and non-inferior to ketoconazole for Pityriasis versicolor 5 and Tinea pedis.…”

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confidence: 99%

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Merkel cell polyomavirus integration‐PCR in bilateral metachronous Merkel cell carcinoma on the nose

Hanner

Wieland

Hartschuh

et al. 2018

Acad Dermatol Venereol

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Late subsequent Merkel cell carcinoma after 21 years of the first primary diagnosis: When to de‐escalate surveillance?

Borda,

Cushman,

Pariser

2024

Clinical Case Reports

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Key Clinical MessageMerkel cell carcinoma (MCC) presents challenges in surveillance due to varied recurrence rates and uncertain follow‐up protocols, especially in late recurrent cases. These cases need personalized monitoring strategies beyond traditional timelines, such as clinical and molecular factors, in order to optimize patient outcomes.AbstractMerkel cell carcinoma (MCC) is a rare, aggressive skin cancer with neuroendocrine differentiation with a propensity for recurrence following initial treatment. Surveillance strategies for MCC patients lack specificity, and the duration of surveillance remains uncertain, posing challenges in identifying appropriate follow‐up intervals. Therefore, we present a 94‐year‐old woman, with history of stage IA MCC in her left nasal wall 21 years prior, that presented with a dome‐shaped eroded nodule on her left fifth finger. Biopsy showed characteristic MCC features with positive immunohistochemistry for CD56, synaptophysin, and CK20 (perinuclear dotting). The patient opted against further imaging or lymph node biopsy and underwent Mohs micrographic surgery. To date, there has not been any evidence of recurrence at previous sites or development of new primary lesions. This case underscores the need for ongoing surveillance despite long disease‐free intervals. It also stands out as the case demonstrating the longest latency/recurrence‐free interval following the initial diagnosis of MCC in the literature. While most recurrences occur within the first few years post‐diagnosis, our case highlights the exceptional nature of late recurrences and prompts reevaluation of surveillance protocols. Current guidelines recommend surveillance for up to 3 years post‐treatment, but factors, such as patient demographics and tumor characteristics, may warrant extended monitoring periods. Emerging biomarkers, such as Merkel cell polyomavirus status and circulating tumor DNA, show promise in predicting and monitoring recurrences, but their utility in late recurrence detection requires further investigation.

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Multiple Merkel cell carcinomas: Late metastasis or multiple primary tumors? A molecular study

Cited by 8 publications

References 10 publications

Clinical features and outcomes of Merkel cell carcinoma in 20 cats

Clinical features and outcomes of Merkel cell carcinoma in 20 cats

Merkel cell polyomavirus integration‐PCR in bilateral metachronous Merkel cell carcinoma on the nose

Late subsequent Merkel cell carcinoma after 21 years of the first primary diagnosis: When to de‐escalate surveillance?

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