The predictive value of imaging studies in evaluating regional lymph node involvement in Merkel cell carcinoma

Colgan, Michael; Tarantola, Tina I.; Weaver, Amy L.; Wiseman, Gregory A.; Roenigk, Randall K.; Brewer, Jerry D.; Otley, Clark C.

doi:10.1016/j.jaad.2012.03.018

Cited by 51 publications

(59 citation statements)

References 14 publications

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“…Thereby, it has most recently shown that, in the evaluation of a regional lymph node based in primary Merkel cell cacinoma (MCC), a rare but agressive skin cancer, 18 F-PET (aka PET-FDG) is significantly more sensitive and equally specific than traditional CT and, both techniques were more sensitive than clinical examination alone [48]. Interestingly, amino-acid analogs such 18 F-choline and 18 F-acetate can alternatively be used to FDG because of their higher specific to tumor cells, so they could play an important role both in differentiating cancers from benign conditions and in diagnosing cancers with either low FDG uptake or high background FDG uptake [49,50].…”

Section: Positron Emission Tomography (Pet)mentioning

confidence: 99%

Importance of Fluorine and Fluorocarbons in Medicinal Chemistry and Oncology

Menaa¹

2013

J Mol Pharm Org Process Res

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Section: Positron Emission Tomography (Pet)mentioning

confidence: 99%

Importance of Fluorine and Fluorocarbons in Medicinal Chemistry and Oncology

Menaa¹

2013

J Mol Pharm Org Process Res

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“…The study was of special interest in MCC since the majority of MCC cases present in the head or neck. In another study of 240 patients with primary MCC evaluated between 1981 and 2008, 99 had diagnostic imaging at initial presentation with biopsy proven primary cutaneous MCC, and had histopathologic nodal evaluation within 4 weeks of the initial scan [32]. The authors showed that computed tomography (n= 69) demonstrated a sensitivity of 47%, a specificity of 97%, a positive predictive value of 94%, and a negative predictive value of 68% in detecting nodal basin involvement.…”

Section: Efficacy In Identifying Microscopically Positive Slns and Ramentioning

confidence: 99%

“…Fluorine-18-fluorodeoxyglucose positron emission tomography scanning (n= 33) demonstrated a sensitivity of 83%, a specificity of 95%, a positive predictive value of 91%, and a negative predictive value of 91% in detecting nodal basin involvement. [32].…”

Section: Efficacy In Identifying Microscopically Positive Slns and Ramentioning

confidence: 99%

“…TTF-1 has been further identified as a transcriptional regulator of thyroid-specific genes. Leukocyte common antigen/CD45 (LCA) is negative in MCC, but classically positive in malignant lymphoma [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. SCLC is usually Cytokeratin 7(CK7) positive, but this marker is negative in MCC.…”

Section: Immunohistochemical (Ihc) Staining On Mccsmentioning

confidence: 99%

“…Neurofilament protein (NFP) is usually positive in MCC, and consistently negative in SCLC. The differentiation between MCC and malignant melanoma is based on the negativity of the latter for CK 20 and its positivity for S-100 and HMB-45; MCC is classically negative for these markers [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. Further, the tumor cells of MCC display additional antigens in varying frequency and intensity; these include Chromogranin A (CgA), synaptophysin, tenascin-C and CD56/NCAM.…”

Section: Immunohistochemical (Ihc) Staining On Mccsmentioning

confidence: 99%

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Merkel cell carcinoma versus metastatic small cell primary bronchogenic carcinoma

Velez¹,

Jackson²,

Lisette³

et al. 2013

Our Dermatol Online

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Introduction: Merkel cell carcinoma (MCC) of the skin is a rare, aggressive, malignant neuroendocrine neoplasm. The tumor classically demonstrates positive immunohistochemistry (IHC) staining for chromogranin A(ChrA), cytokeratin 20 (CK20), neuron specific enolase (NSE) and/or achaete-acute complex-like 1 (MASH1). The newly identified Merkel cell polyomavirus (MCPyV) has been found to be associated with most MCC cases. The primary histologic differential diagnoses of cutaneous MCC is small cell primary bronchogenic carcinoma (SCLC); moreover, both are of neuroendocrine origin. SCLC accounts for approximately 10-15% of all primary lung cancer cases; this histologic subtype is a distinct entity with biological and oncological features distinct from non-small cell lung cancer (NSCLC). In contradistinction to MCC, SCLC is classically IHC positive for cytokeratin 7 (CK7) and transcription factor (TTF-1). Similar to SCLC, MCC cell lines may be classified into two different biochemical subgroups designated as Classic and Variant. In our review and case report, we aim to emphasize the importance of a multidisciplinary approach to the approach to this difficult differential diagnosis. We also aim to comment about features of the cells of origin of MCC and SCLC; to summarize the microscopic features of both tumors; and to review their respective epidemiologic, clinical, prognostic and treatment features. We want to emphasize the initial workup study of the differential diagnosis patient, including evaluating clinical lymph nodes, a clinical history of any respiratory abnormality, and chest radiogram. If a diagnosis of primary cutaneous MCC is confirmed, classic treatment includes excision of the primary tumor with wide margins, excision of a sentinel lymph node, and computed tomography, positron emission tomography and/or Fluorine-18-fluorodeoxyglucose positron emission tomography scan studies.Key words: Merkel cell carcinoma; thyroid transcription factor; somatostatin; IMP3; small cell lung carcinoma (SCLC) Abbreviations and acronyms: Merkel cell carcinoma (MCC), thyroid transcription factor 1 (TTF-1), immunohistochemistry (IHC), neuron specific enolase (NSE), small cell lung carcinoma (SCLC), chromogranin A(CgA), insulin-like growth factor II mRNA binding protein 3 (IMP3), neurofilament protein (NF), cytokeratin 7 (CK7), cytokeratin 20 (CK20), surveillance, epidemiology, and end results (SEER), non-small cell lung cancer (NSCLC), computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MRI), Merkel cell polyoma virus (MCPyV). MERKEL CELL CARCINOMA VERSUS METASTATIC SMALL CELL PRIMARY BRONCHOGENIC CARCINOMA IntroductionMerkel cell carcinoma (MCC) of the skin is an aggressive but rare malignant neuroendocrine tumor. This tumor has a high rate of recurrence and metastasis the main histopathological differential diagnosis is cell lung carcinoma (SCLC). Most MCC are usually positive to cytokeratin 20 (CK20) stain as well as may show some neuroendocrine differentiation, expressing eit...

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Rapidly Growing Eyelid Mass in an Elderly Man

2018

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A 90 year-old Chinese man presented with a rapidly-growing left upper lid lesion. The lesion first appeared two months prior to presentation as a 1 cm red, painless nodule. He denied trauma or changes to his vision. His past medical history was negative for malignancy. He had a history of cataract surgery in the left eye and end-staged bilateral nonneovascular age-related macular degeneration. On exam, his vision was hand-motion OD and 20/200 OS. His intraocular pressures were normal and extraocular motility full. His pupils were equal and reactive to light without an afferent pupillary defect. The external exam revealed a left upper lid exophytic mass with areas of necrosis. The mass extended medially to the punctum, superiorly to the upper eyelid crease and laterally to lateral canthus (Figure 1A). He had appreciable lymphadenopathy of the head and neck. Cranial nerves V and VII were intact bilaterally. Anterior segment exam showed diffuse conjunctival chemosis OS, white and quiet conjunctiva and sclera OD, clear corneas OU, deep and quiet anterior chambers OU, a dense cataract OD, and PC/IOL OS. B scan of the right eye showed no masses or retinal detachment. A dilated fundoscopic exam showed evidence of a chronic left hemiretinal vein occlusion.An incisional biopsy was performed, and pathologic inspection revealed pleomorphic, basophilic cells with positive cytokeratin-20 and cytoplasmic synaptophysin staining. Magnetic resonance imaging (MRI) (Figure 1B) revealed a 4.3 cm tumor with periorbital soft tissue extension without post-septal involvement and a 1.4 cm mass of the left parotid gland. DIAGNOSIS Merkel cell carcinomaWhat would you do next? 1.Sentinel lymph node biopsy 2.Full body PET scan 3.Lumbar puncture 4.Fine needle aspiration of the parotid mass

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The predictive value of imaging studies in evaluating regional lymph node involvement in Merkel cell carcinoma

Cited by 51 publications

References 14 publications

Importance of Fluorine and Fluorocarbons in Medicinal Chemistry and Oncology

Importance of Fluorine and Fluorocarbons in Medicinal Chemistry and Oncology

Merkel cell carcinoma versus metastatic small cell primary bronchogenic carcinoma

Rapidly Growing Eyelid Mass in an Elderly Man

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