Spontaneous regression in an ulcerated CK7 positive Merkel cell carcinoma

Abstract

Merkel cell carcinoma is an aggressive and frequently lethal tumor of the elderly, associated with sun exposure and immunosuppression which is less common in the dark-skinned. We report the case of a 40-year-old woman who presented with multiple slowly progressive, mildly itchy ulcerated plaques of size ranging from 2 × 3 cm to 5 × 7 cm on the left knee of 1 year duration. Skin biopsy showed diffuse dermal infiltration by small round cells with molding of cells and lymphocyte infiltration. The cells stained positive for cytokeratin (CK) 20, CK7, neuron-specific enolase, and chromogranin. The skin lesions underwent spontaneous regression within 1 month of skin biopsy and have not recurred during the past 2 years. The immune mechanisms triggered by biopsy possibly explain the spontaneous regression.

Immunotherapy in Merkel cell carcinoma: role of Avelumab

“…Cytokeratin (CK) 20 is another marker to detect these cells and the cancer is typically positive for CK-20 and negative for CK-7, though rare cases with positive CK-7 have been reported. 3 …”