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Valentini R, Grant-Kels JM, Falcone M, Stewart CL. Merkel cell carcinoma and the eye. Clin Dermatol 2024:S0738-081X(24)00010-5. [PMID: 38325726 DOI: 10.1016/j.clindermatol.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine tumor with a poor five-year survival rate. Yearly cases have risen nearly 350% since the early 1980s, and these are predicted to increase as the overall US population ages. MCC of the eyelid is uncommon and can be misdiagnosed as other benign inflammatory and neoplastic eyelid disorders. Although MCC of the head and neck is often more aggressive than it is at other sites, eyelid MCC shows a lower disease-specific mortality rate. A biopsy is essential for accurate diagnosis, including an immunohistochemical panel of CK20 and TTF-1, although other markers may be necessary. Staging can be assessed clinically through physical examination findings and imaging and/or pathologically with sentinel lymph node biopsy or fine-needle aspiration. Pathologic staging more accurately predicts the prognosis. Eyelid MCC treatments include Mohs micrographic surgery to allow for complete clearance and adequate reconstruction of lost tissue, followed by adjuvant radiotherapy. In advanced disease, immunotherapies are preferred over traditional chemotherapy and are a subject of ongoing research.
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Affiliation(s)
- Rodolfo Valentini
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Madina Falcone
- Department of Surgery, Division of Ophthalmology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Campbell L Stewart
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
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2
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Boileau M, Dubois M, Abi Rached H, Escande A, Mirabel X, Mortier L. An Effective Primary Treatment Using Radiotherapy in Patients with Eyelid Merkel Cell Carcinoma. Curr Oncol 2023; 30:6353-6361. [PMID: 37504328 PMCID: PMC10377768 DOI: 10.3390/curroncol30070468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a rare type of neuroendocrine tumor. Palpebral localization represents 2.5% of MCCs. Surgery is not always possible due to the localization or comorbidities of elderly patients. We hypothesized that radiotherapy (RT) alone could be a curative treatment in patients contraindicated for oncological surgery. METHODS We performed a retrospective monocentric study of patients with localized eyelid MCC treated with curative intent using curative radiotherapy. RESULTS Overall, 11 patients with histologically confirmed eyelid MCC were treated with curative radiotherapy. The median age was 77 years old (range: 53-94). Curative RT was decided mainly due to difficult localization and significant co-morbidities. The median lesion dose was 57 Gy (range: 47-70). Most patients had adjuvant lymph nodes irradiation with a median dose of 50 Gy (n = 9; 82%). The median follow-up was 62 months (6-152 months). None of the seven deaths were MCC-related. None of our patients relapsed during follow-up. Side effects related to radiotherapy were mild (no grade ≥ 2) and rare (n = 3, 21%). CONCLUSION Our data suggest that curative radiotherapy is an effective and safe treatment for Merkel cell carcinoma of the eyelid and periocular region. Radiotherapy alone allows limiting the aesthetic and functional sequelae in elderly and comorbid patients who are contraindicated for oncological surgery.
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Affiliation(s)
- Marie Boileau
- CHU Lille, Department of Dermatology, University of Lille, F-59000 Lille, France
- Department of Medicine, University of Lille, H.Warembourg, F-59000 Lille, France
| | - Manon Dubois
- CHU Lille, Department of Dermatology, University of Lille, F-59000 Lille, France
- Department of Medicine, University of Lille, H.Warembourg, F-59000 Lille, France
| | - Henry Abi Rached
- CHU Lille, Department of Dermatology, University of Lille, F-59000 Lille, France
- Department of Medicine, University of Lille, H.Warembourg, F-59000 Lille, France
| | - Alexandre Escande
- Department of Medicine, University of Lille, H.Warembourg, F-59000 Lille, France
- CRIStAL Laboratory, UMR 9189, University of Lille, F-59655 Villeneuve d'Ascq, France
- CHU Lille, University of Lille, Inserm, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France
| | - Xavier Mirabel
- Oscar Lambret Comprehensive Cancer Center, Universitary Department of Radiation Oncology, F-59000 Lille, France
| | - Laurent Mortier
- CHU Lille, Department of Dermatology, University of Lille, F-59000 Lille, France
- Department of Medicine, University of Lille, H.Warembourg, F-59000 Lille, France
- CHU Lille, University of Lille, Inserm, U1189-ONCO-THAI-Assisted Laser Therapy and Immunotherapy for Oncology, F-59000 Lille, France
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3
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Sensory nerve sprouting of human skin explants confers improved survival to Merkel cells independent of Merkel cell-neurite complexes. J Invest Dermatol 2023:S0022-202X(23)00157-4. [PMID: 36863447 DOI: 10.1016/j.jid.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 03/02/2023]
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4
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Mazziotta C, Cervellera CF, Lanzillotti C, Touzé A, Gaboriaud P, Tognon M, Martini F, Rotondo JC. MicroRNA dysregulations in Merkel cell carcinoma: Molecular mechanisms and clinical applications. J Med Virol 2023; 95:e28375. [PMID: 36477874 DOI: 10.1002/jmv.28375] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
Merkel cell carcinoma (MCC) is an aggressive skin malignancy with two distinct etiologies. The first, which accounts for the highest proportion, is caused by Merkel cell polyomavirus (MCPyV), a DNA tumor virus. A second, UV-induced, MCC form has also been identified. Few MCC diagnostic, prognostic, and therapeutic options are available. MicroRNAs (miRNAs) are small noncoding RNA molecules, which play a key role in regulating various physiologic cellular functions including cell cycling, proliferation, differentiation, and apoptosis. Numerous miRNAs are dysregulated in cancer, by acting as either tumor suppressors or oncomiRs. The aim of this review is to collect, summarize, and discuss recent findings on miRNAs whose dysregulation has been assumed to play a role in MCC. The potential clinical application of miRNAs as diagnostic and prognostic biomarkers in MCC is also described. In the future, miRNAs will potentially gain clinical significance for the improvement of MCC diagnostic, prognostic, and therapeutic options.
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Affiliation(s)
- Chiara Mazziotta
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Department of Medical Sciences, Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | | | - Carmen Lanzillotti
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Department of Medical Sciences, Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Antoine Touzé
- "Biologie des infections à polyomavirus" Team, UMR INRAE 1282, University of Tours, Tours, France
| | - Pauline Gaboriaud
- "Biologie des infections à polyomavirus" Team, UMR INRAE 1282, University of Tours, Tours, France
| | - Mauro Tognon
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fernanda Martini
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Department of Medical Sciences, Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy.,Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - John Charles Rotondo
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Department of Medical Sciences, Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
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5
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Lewis DJ, Sobanko JF, Etzkorn JR, Shin TM, Giordano CN, McMurray SL, Walker JL, Zhang J, Miller CJ, Higgins HW. Merkel Cell Carcinoma. Dermatol Clin 2022; 41:101-115. [DOI: 10.1016/j.det.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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6
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Michalak-Micka K, Rütsche D, Mazzone L, Büchler VL, Moehrlen U, Klar AS, Biedermann T. Human fetal skin derived merkel cells display distinctive characteristics in vitro and in bio-engineered skin substitutes in vivo. Front Bioeng Biotechnol 2022; 10:983870. [PMID: 36185452 PMCID: PMC9520781 DOI: 10.3389/fbioe.2022.983870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Human skin contains specialized neuroendocrine Merkel cells responsible for fine touch sensation. In the present study, we performed in-depth analysis of Merkel cells in human fetal back skin. We revealed that these Merkel cells expressed cytokeratin 20 (CK20), were positive for the neuroendocrine markers synaptophysin and chromogranin A, and the mechanosensitive ion channel Piezo2. Further, we demonstrated that Merkel cells were present in freshly isolated human fetal epidermal cells in vitro, and in tissue-engineered human dermo-epidermal skin substitutes 4 weeks after transplantation on immune-compromised rats. Merkel cells retained the expression of CK20, synaptophysin, chromogranin A, and Piezo2 after isolation and in culture, and in the skin substitutes after transplantation. Interestingly, we observed that in fetal skin and in skin substitutes, only Merkel cells were positive for CK8, while in culture, also non-Merkel cells showed positivity for CK8. In summary, human fetal Merkel cells showed phenotypical features confirming their cell identity. This findings are of pivotal importance for the future application of fetal tissue-engineered skin in clinics.
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Affiliation(s)
- Katarzyna Michalak-Micka
- Tissue Biology Research Unit, Department of Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center (CRC), University Children’s Hospital Zurich, Zurich, Switzerland
| | - Dominic Rütsche
- Tissue Biology Research Unit, Department of Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center (CRC), University Children’s Hospital Zurich, Zurich, Switzerland
| | - Luca Mazzone
- Children’s Research Center (CRC), University Children’s Hospital Zurich, Zurich, Switzerland
- Spina Bifida Center, University Children’s Hospital Zurich, Zurich, Switzerland
- The Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
| | - Vanessa L. Büchler
- Tissue Biology Research Unit, Department of Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center (CRC), University Children’s Hospital Zurich, Zurich, Switzerland
| | - Ueli Moehrlen
- Children’s Research Center (CRC), University Children’s Hospital Zurich, Zurich, Switzerland
- Spina Bifida Center, University Children’s Hospital Zurich, Zurich, Switzerland
- The Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Agnes S. Klar
- Tissue Biology Research Unit, Department of Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center (CRC), University Children’s Hospital Zurich, Zurich, Switzerland
| | - Thomas Biedermann
- Tissue Biology Research Unit, Department of Surgery, University Children’s Hospital Zurich, Zurich, Switzerland
- Children’s Research Center (CRC), University Children’s Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- *Correspondence: Thomas Biedermann,
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Merkel Cell Carcinoma of the Left Eyelid with Metastasis to the Left Submandibular Lymph Nodes: A Case Report and Brief Review. Case Rep Ophthalmol Med 2022; 2022:4712301. [PMID: 35251726 PMCID: PMC8894019 DOI: 10.1155/2022/4712301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/01/2022] [Indexed: 11/18/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a cutaneous cancer often found on sun-exposed areas. MCC is rare but very often lethal making early diagnosis challenging although critical. There are only a few cases that have reported MCC of the eyelid making it often hard to identify in clinic. A 52-year-old woman with a firm nodule on the left eyelid was diagnosed with MCC that had also metastasized to a left submandibular lymph node. She underwent surgical excision of the mass and lymph node as well as parotid gland and neck dissection to rule out other metastases and then underwent radiation therapy. The aim of this study is to report a case of eyelid MCC with metastasis to a local lymph node to provide another example of the rare cancer in hopes that diagnosis and treatment options for MCC are more thoroughly studied and understood.
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8
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Sundqvist B, Sihto H, von Willebrand M, Böhling T, Koljonen V. LRIG1 is a positive prognostic marker in Merkel cell carcinoma and Merkel cell carcinoma expresses epithelial stem cell markers. Virchows Arch 2021; 479:1197-1207. [PMID: 34331569 PMCID: PMC8724115 DOI: 10.1007/s00428-021-03158-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/09/2021] [Accepted: 07/11/2021] [Indexed: 12/24/2022]
Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine malignancy of the skin. The cell of origin of MCC is thus far unknown and proposed cells of origin include Merkel cells, pro-/pre- or pre-B cells, epithelial stem cells, and dermal stem cells. In this study, we aimed to shed further light on the possibility that a subset of MCC tumors arise from epithelial stem cells of the skin by examining the expression of hair follicle and epidermal stem cell markers in MCC and normal human skin. We also aimed to elucidate any correlation between the expression of these markers and tumor Merkel cell polyomavirus (MCPyV) status or other clinicopathological characteristics or patient survival. Expression of CK19, SOX9, LGR5, and LRIG1 in MCC and normal human skin was studied by immunohistochemistry, and the staining patterns or intensities were statistically correlated with patient, tumor, MCPyV, and survival parameters. In a cohort of 137 cases of MCC, we observed dot-like immunoexpression of CK19 in 30 cases (22.1%) and homogeneous expression in 103 cases (75.7%). We also observed positive immunoexpression of SOX9 in 21 cases (15.3%), LGR5 in 118 cases (86.1%), and LRIG1 in 117 cases (86.0%). Immunoexpression of LRIG1 was found to correlate with better overall and MCC-specific survival. We observed frequent immunoexpression of several hair follicle and epidermal stem cell markers in MCC and found LRIG1 to be a positive prognostic marker in MCC.
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Affiliation(s)
- Benjamin Sundqvist
- Department of Pathology, Haartman Institute, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland.
| | - Harri Sihto
- Department of Pathology, Haartman Institute, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland
| | - Maria von Willebrand
- Department of Pathology, Haartman Institute, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland
| | - Tom Böhling
- Department of Pathology, Haartman Institute, University of Helsinki, P.O. Box 21, 00014, Helsinki, Finland
| | - Virve Koljonen
- Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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9
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Orouji E, Peitsch WK, Orouji A, Houben R, Utikal J. Unique Role of Histone Methyltransferase PRDM8 in the Tumorigenesis of Virus-Negative Merkel Cell Carcinoma. Cancers (Basel) 2020; 12:cancers12041057. [PMID: 32344701 PMCID: PMC7226539 DOI: 10.3390/cancers12041057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a deadly skin cancer, and about 80% of its cases have been shown to harbor integrated Merkel polyomavirus in the tumor cell genome. Viral oncoproteins expressed in the tumor cells are considered as the oncogenic factors of these virus-positive Merkel cell carcinoma (VP-MCC). In contrast, the molecular pathogenesis of virus-negative MCC (VN-MCC) is less well understood. Using gene expression analysis of MCC cell lines, we found histone methyltransferase PRDM8 to be elevated in VN-MCC. This finding was confirmed by immunohistochemical analysis of MCC tumors, revealing that increased PRDM8 expression in VN-MCC is also associated with increased H3K9 methylation. CRISPR-mediated silencing of PRDM8 in MCC cells further supported the histone methylating role of this protein in VN-MCC. We also identified miR-20a-5p as a negative regulator of PRDM8. Taken together, our findings provide insights into the role of PRDM8 as a histone methyltransferase in VN-MCC tumorigenesis.
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Affiliation(s)
- Elias Orouji
- Skin Cancer Unit, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
- Department of Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
- Correspondence: (E.O.); (J.U.); Tel.: +1-(917)647-2202 (E.O.); +49-(621)383-4461 (J.U.)
| | - Wiebke K. Peitsch
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, 10249 Berlin, Germany
| | - Azadeh Orouji
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
| | - Roland Houben
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Jochen Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, 68167 Mannheim, Germany
- Correspondence: (E.O.); (J.U.); Tel.: +1-(917)647-2202 (E.O.); +49-(621)383-4461 (J.U.)
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10
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11
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Carcinoma de células de Merkel: diagnóstico y tratamiento en atención especializada dermatológica. Guía de práctica clínica de la Academia Española de Dermatología y Venerología. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:460-468. [DOI: 10.1016/j.ad.2019.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 12/30/2022] Open
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12
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Doval JV, Cussac BL, Bustillo AP, Morena SPDL, González MF, Figueras MF, Villanueva M, Salas NR, Descalzo-Gallego M, García-Doval I, Ríos-Buceta L. Diagnosis and Treatment of Merkel Cell Carcinoma in Specialized Dermatology Units: A Clinical Practice Guideline of the Spanish Academy of Dermatology and Venereology. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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13
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Kervarrec T, Samimi M, Guyétant S, Sarma B, Chéret J, Blanchard E, Berthon P, Schrama D, Houben R, Touzé A. Histogenesis of Merkel Cell Carcinoma: A Comprehensive Review. Front Oncol 2019; 9:451. [PMID: 31245285 PMCID: PMC6579919 DOI: 10.3389/fonc.2019.00451] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 05/13/2019] [Indexed: 12/11/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a primary neuroendocrine carcinoma of the skin. This neoplasia features aggressive behavior, resulting in a 5-year overall survival rate of 40%. In 2008, Feng et al. identified Merkel cell polyomavirus (MCPyV) integration into the host genome as the main event leading to MCC oncogenesis. However, despite identification of this crucial viral oncogenic trigger, the nature of the cell in which MCC oncogenesis occurs is actually unknown. In fact, several hypotheses have been proposed. Despite the large similarity in phenotype features between MCC tumor cells and physiological Merkel cells (MCs), a specialized subpopulation of the epidermis acting as mechanoreceptor of the skin, several points argue against the hypothesis that MCC derives directly from MCs. Alternatively, MCPyV integration could occur in another cell type and induce acquisition of an MC-like phenotype. Accordingly, an epithelial as well as a fibroblastic or B-cell origin of MCC has been proposed mainly based on phenotype similarities shared by MCC and these potential ancestries. The aim of this present review is to provide a comprehensive review of the current knowledge of the histogenesis of MCC.
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Affiliation(s)
- Thibault Kervarrec
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Tours, France.,ISP "Biologie des infections à polyomavirus" team, UMR INRA 1282, University of Tours, Tours, France.,Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Mahtab Samimi
- ISP "Biologie des infections à polyomavirus" team, UMR INRA 1282, University of Tours, Tours, France.,Departement of Dermatology, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Serge Guyétant
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Tours, France.,ISP "Biologie des infections à polyomavirus" team, UMR INRA 1282, University of Tours, Tours, France
| | - Bhavishya Sarma
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Jérémy Chéret
- Monasterium Laboratory, Skin and Hair Research Solutions GmbH, Münster, Germany
| | - Emmanuelle Blanchard
- Department of Pathology, Centre Hospitalier Universitaire de Tours, Tours, France.,Plateforme IBiSA de Microscopie Electronique, INSERM 1259, Université de Tours, Tours, France
| | - Patricia Berthon
- ISP "Biologie des infections à polyomavirus" team, UMR INRA 1282, University of Tours, Tours, France
| | - David Schrama
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Roland Houben
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Antoine Touzé
- ISP "Biologie des infections à polyomavirus" team, UMR INRA 1282, University of Tours, Tours, France
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14
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Merkel cell carcinoma of the eyelid: A review. Surv Ophthalmol 2019; 64:659-667. [PMID: 30871952 DOI: 10.1016/j.survophthal.2019.03.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
Merkel cell carcinoma (MCC) is a rare, aggressive tumor of both epithelial and neuroendocrine origin, which carries a mortality rate of up to 40%. MCC tumors typically present as painless, expanding nodules on the sun-exposed skin areas of older, white patients. Eyelid and periocular tumors comprise approximately 2.5% of all cases of MCC and may be mistaken for chalazia or basal cell carcinomas. Immunosuppression is a significant risk factor, particularly in solid-organ-transplant recipients, patients with chronic lymphocytic leukemia, and patients with HIV. Sentinel lymph node biopsy is often used for accurate staging of head and neck MCC. Treatment includes wide local excision, commonly with the addition of radiotherapy for improved locoregional disease control. Historically, adjuvant chemotherapy had been reserved for metastatic disease, but immunotherapy and targeted chemotherapies are currently being investigated for use in primary disease. The clinical characteristics of all available published cases of eyelid MCC are summarized in this article.
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15
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Hahn JM, Combs KA, Lloyd CM, McFarland KL, Boyce ST, Supp DM. Identification of Merkel cells associated with neurons in engineered skin substitutes after grafting to full thickness wounds. PLoS One 2019; 14:e0213325. [PMID: 30835771 PMCID: PMC6400390 DOI: 10.1371/journal.pone.0213325] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 02/18/2019] [Indexed: 02/07/2023] Open
Abstract
Engineered skin substitutes (ESS), prepared using primary human fibroblasts and keratinocytes with a biopolymer scaffold, were shown to provide stable closure of excised burns, but relatively little is known about innervation of ESS after grafting. This study investigated innervation of ESS and, specifically, whether Merkel cells are present in healed grafts. Merkel cells are specialized neuroendocrine cells required for fine touch sensation in skin. We discovered cells positive for keratin 20 (KRT20), a general marker for Merkel cells, in the basal epidermis of ESS after transplantation to mice, suggesting the presence of Merkel cells. Cells expressing KRT20 were not observed in ESS in vitro. However, widely separated KRT20-positive cells were observed in basal epidermis of ESS by 2 weeks after grafting. By 4 weeks, these cells increased in number and expressed keratins 18 and 19, additional Merkel cells markers. Putative Merkel cell numbers increased further between weeks 6 and 14; their densities varied widely and no specific pattern of organization was observed, similar to Merkel cell localization in human skin. KRT20-positive cells co-expressed epidermal markers E-cadherin and keratin 15, suggesting derivation from the epidermal lineage, and neuroendocrine markers synaptophysin and chromogranin A, consistent with their identification as Merkel cells. By 4 weeks after grafting, some Merkel cells in engineered skin were associated with immature afferents expressing neurofilament-medium. By 8 weeks, Merkel cells were complexed with more mature neurons expressing neurofilament-heavy. Positive staining for human leukocyte antigen demonstrated that the Merkel cells in ESS were derived from grafted human cells. The results identify, for the first time, Merkel cell-neurite complexes in engineered skin in vivo. This suggests that fine touch sensation may be restored in ESS after grafting, although this must be confirmed with future functional studies.
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Affiliation(s)
- Jennifer M. Hahn
- Research Department, Shriners Hospitals for Children – Cincinnati, Cincinnati, Ohio, United States of America
| | - Kelly A. Combs
- Research Department, Shriners Hospitals for Children – Cincinnati, Cincinnati, Ohio, United States of America
| | - Christopher M. Lloyd
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Kevin L. McFarland
- Research Department, Shriners Hospitals for Children – Cincinnati, Cincinnati, Ohio, United States of America
| | - Steven T. Boyce
- Research Department, Shriners Hospitals for Children – Cincinnati, Cincinnati, Ohio, United States of America
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Dorothy M. Supp
- Research Department, Shriners Hospitals for Children – Cincinnati, Cincinnati, Ohio, United States of America
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
- * E-mail:
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16
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Prodinger CM, Koller J, Laimer M. Scalp tumors. J Dtsch Dermatol Ges 2018; 16:730-753. [DOI: 10.1111/ddg.13546] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 04/10/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Christine Maria Prodinger
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
| | - Josef Koller
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
| | - Martin Laimer
- Department of Dermatology; Salzburg Regional Medical Center; Paracelsus Medical University; Salzburg Austria
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17
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Prodinger CM, Koller J, Laimer M. Tumoren der Kopfhaut. J Dtsch Dermatol Ges 2018; 16:730-754. [DOI: 10.1111/ddg.13546_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 04/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Christine Maria Prodinger
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
| | - Josef Koller
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
| | - Martin Laimer
- Universitätsklinik für Dermatologie; Salzburger Landesklinken - Uniklinikum der Paracelsus Medizinischen Privatuniversität Salzburg; Österreich
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18
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Becker JC, Stang A, Hausen AZ, Fischer N, DeCaprio JA, Tothill RW, Lyngaa R, Hansen UK, Ritter C, Nghiem P, Bichakjian CK, Ugurel S, Schrama D. Epidemiology, biology and therapy of Merkel cell carcinoma: conclusions from the EU project IMMOMEC. Cancer Immunol Immunother 2018; 67:341-351. [PMID: 29188306 PMCID: PMC6015651 DOI: 10.1007/s00262-017-2099-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 11/24/2017] [Indexed: 01/23/2023]
Abstract
Merkel cell carcinoma (MCC) is a highly aggressive, often lethal neuroendocrine cancer. Its carcinogenesis may be either caused by the clonal integration of the Merkel cell polyomavirus into the host genome or by UV-induced mutations. Notably, virally-encoded oncoproteins and UV-induced mutations affect comparable signaling pathways such as RB restriction of cell cycle progression or p53 inactivation. Despite its low incidence, MCC recently received much attention based on its exquisite immunogenicity and the resulting major success of immune modulating therapies. Here, we summarize current knowledge on epidemiology, biology and therapy of MCC as conclusion of the project 'Immune Modulating strategies for treatment of Merkel Cell Carcinoma', which was funded over a 5-year period by the European Commission to investigate innovative immunotherapies for MCC.
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Affiliation(s)
- Jürgen C Becker
- Translational Skin Cancer Research (tscr), German Cancer Consortium (DKTK), University Hospital of Essen, Universitätsstrasse 1, S05 T05 B, 45141, Essen, Germany.
- German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Department of Dermatology, University Hospital of Essen, Essen, Germany.
| | - Andreas Stang
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center of Clinical Epidemiology; c/o Institute of Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Axel Zur Hausen
- Department of Pathology, Academisch Ziekenhuis Maastricht, Maastricht, The Netherlands
| | - Nicole Fischer
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - James A DeCaprio
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | | | - Rikke Lyngaa
- Section for Immunology and Vaccinology, National Veterinary Institute, Technical University of Denmark, Copenhagen, Denmark
| | - Ulla Kring Hansen
- George F. Odland Endowed Chair in Dermatology, University of Washington, Seattle, WA, USA
| | - Cathrin Ritter
- Translational Skin Cancer Research (tscr), German Cancer Consortium (DKTK), University Hospital of Essen, Universitätsstrasse 1, S05 T05 B, 45141, Essen, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paul Nghiem
- George F. Odland Endowed Chair in Dermatology, University of Washington, Seattle, WA, USA
| | | | - Selma Ugurel
- Department of Dermatology, University Hospital of Essen, Essen, Germany
| | - David Schrama
- Department of Dermatology, University Hospital Wuerzburg, Würzburg, Germany
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19
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Abstract
Merkel cell carcinoma (MCC) is an uncommon primary cutaneous neuroendocrine cancer. It most commonly presents as an indurated plaque or nodule on sun-damaged skin in elderly patients and is characterized by high rates of local recurrence and nodal metastasis. Survival at 5 years is 51% for local disease and as low as 14% for distant disease, which underscores the aggressive nature of this tumor and challenges in management. Advances in immunology and molecular genetics have broadened our understanding of the pathophysiology of MCC and expanded our therapeutic arsenal. With this comprehensive review, we provide an update of MCC epidemiology, pathogenesis, clinical presentation, diagnostic evaluation and prognostic markers. The second article in this continuing medical education series explores the evolving landscape in MCC management.
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20
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Galloway DA. The Murky Life of Merkel Cell Polyomavirus. Cell Host Microbe 2017; 19:747-8. [PMID: 27281563 DOI: 10.1016/j.chom.2016.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Merkel cell polyomavirus (MCPyV) expressing viral T antigens is a common feature of most Merkel cell carcinomas, a primary neuroendocrine skin tumor. MCPyV has been difficult to propagate in vitro. In this issue of Cell Host & Microbe, Liu et al. (2016) report that human dermal fibroblasts support productive MCPyV infection.
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Affiliation(s)
- Denise A Galloway
- Division of Human Biology, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109, USA.
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21
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Abstract
Merkel cell carcinoma (MCC) is a rare but highly aggressive skin cancer with neuroendocrine features. MCC pathogenesis is associated with either the presence of Merkel cell polyomavirus or chronic exposure to ultraviolet light (UV), which can cause a characteristic pattern of multiple DNA mutations. Notably, in the Northern hemisphere, the majority of MCC cases are of viral aetiology; by contrast, in areas with high UV exposure, UV-mediated carcinogenesis is predominant. The two aetiologies share similar clinical, histopathological and prognostic characteristics. MCC presents with a solitary cutaneous or subcutaneous nodule, most frequently in sun-exposed areas. In fact, UV exposure is probably involved in both viral-mediated and non-viral-mediated carcinogenesis, by contributing to immunosuppression or DNA damage, respectively. Confirmation of diagnosis relies on analyses of histological features and immunological marker expression profiles of the lesion. At primary diagnosis, loco-regional metastases are already present in ∼30% of patients. Excision of the tumour is the first-line therapy; if not feasible, radiotherapy can often effectively control the disease. Chemotherapy was the only alternative in advanced-stage or refractory MCC until several clinical trials demonstrated the efficacy of immune-checkpoint inhibitors.
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22
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Bertolini M, Pretzlaff M, Sulk M, Bähr M, Gherardini J, Uchida Y, Reibelt M, Kinori M, Rossi A, Bíró T, Paus R. Vasoactive intestinal peptide, whose receptor-mediated signalling may be defective in alopecia areata, provides protection from hair follicle immune privilege collapse. Br J Dermatol 2016; 175:531-41. [PMID: 27059672 DOI: 10.1111/bjd.14645] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alopecia areata (AA) is an autoimmune disorder whose pathogenesis involves the collapse of the relative immune privilege (IP) of the hair follicle (HF). Given that vasoactive intestinal peptide (VIP) is an immunoinhibitory neuropeptide released by perifollicular sensory nerve fibres, which play a role in IP maintenance, it may modulate human HF-IP and thus be therapeutically relevant for AA. OBJECTIVES To answer the following questions: Do human HFs express VIP receptors, and does their stimulation protect from or restore experimentally induced HF-IP collapse? Is VIP signalling defective in AA HFs? METHODS Firstly, VIP and VIP receptor (VPAC1, VPAC2) expression in human scalp HFs and AA skin was assessed. In HF organ culture, we then explored whether VIP treatment can restore and/or protect from interferon-γ-induced HF-IP collapse, assessing the expression of the key IP markers by quantitative (immuno-)histomorphometry. RESULTS Here we provide the first evidence that VIP receptors are expressed in the epithelium of healthy human HFs at the gene and protein level. Furthermore, VIP receptor protein expression, but not VIP(+) nerve fibres, is significantly downregulated in lesional hair bulbs of patients with AA, suggesting defects in VIP receptor-mediated signalling. Moreover, we show that VIP protects the HF from experimentally induced IP collapse in vitro, but does not fully restore it once collapsed. CONCLUSIONS These pilot data suggest that insufficient VIP receptor-mediated signalling may contribute to impairing HF-IP in patients with AA, and that VIP is a promising candidate 'HF-IP guardian' that may be therapeutically exploited to inhibit the progression of AA lesions.
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Affiliation(s)
- M Bertolini
- Department of Dermatology, University of Münster, Münster, Germany.
| | - M Pretzlaff
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - M Sulk
- Department of Dermatology, University of Münster, Münster, Germany
| | - M Bähr
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - J Gherardini
- Department of Dermatology, University of Münster, Münster, Germany
| | - Y Uchida
- Department of Dermatology, University of Münster, Münster, Germany.,Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - M Reibelt
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - M Kinori
- Department of Ophthalmology, Sheba Medical Center, Tel Hashomer, Israel
| | - A Rossi
- Department of Internal Medicine and Medical Specialties, University 'La Sapienza', Rome, Italy
| | - T Bíró
- DE-MTA 'Lendület' Cellular Physiology Research Group, Departments of Immunology and Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - R Paus
- Department of Dermatology, University of Münster, Münster, Germany.,Centre for Dermatology Research, Institute of Inflammation and Repair, University of Manchester, Manchester, U.K
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Policarpio-Nicolas MLC, Avery DL, Hartley T. Merkel cell carcinoma presenting as malignant ascites: A case report and review of literature. Cytojournal 2015; 12:19. [PMID: 26425135 PMCID: PMC4564912 DOI: 10.4103/1742-6413.162775] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 07/05/2015] [Indexed: 01/03/2023] Open
Abstract
The most common site of metastasis to ascitic fluid in females is from a mullerian (ovarian) primary, whereas in males it is from the gastrointestinal tract. Metastatic Merkel cell carcinoma (MCC) to the ascitic fluid is extremely rare and may present as a diagnostic challenge on effusion cytology. In a review of the literature, there are only two case reports of metastatic MCC in pleural effusion. To the best of our knowledge, we present the first cytological diagnosis of MCC metastatic to the ascitic fluid. We describe the cytologic findings as well as the immunohistochemical stains supportive of the diagnosis. Given the fatal prognosis of this tumor compared to melanoma and rarity of its occurrence in ascitic fluid, awareness of this tumor and use of immunohistochemical stains are critical in arriving at the diagnosis.
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Affiliation(s)
| | - Diane L Avery
- Department of Pathology, University Hospital, San Antonio, TX, USA
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25
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The Histochemistry and Cell Biology pandect: the year 2014 in review. Histochem Cell Biol 2015; 143:339-68. [PMID: 25744491 DOI: 10.1007/s00418-015-1313-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2015] [Indexed: 02/07/2023]
Abstract
This review encompasses a brief synopsis of the articles published in 2014 in Histochemistry and Cell Biology. Out of the total of 12 issues published in 2014, two special issues were devoted to "Single-Molecule Super-Resolution Microscopy." The present review is divided into 11 categories, providing an easy format for readers to quickly peruse topics of particular interest to them.
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Merkel cell carcinoma - recent advances in the biology, diagnostics and treatment. Int J Biochem Cell Biol 2014; 53:536-46. [PMID: 24811434 DOI: 10.1016/j.biocel.2014.04.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 04/27/2014] [Accepted: 04/28/2014] [Indexed: 11/24/2022]
Abstract
Merkel cell carcinoma (MCC) is an uncommon primary cutaneous carcinoma with neuroendocrine differentiation. Since recent discovery of MCCs strong association with Merkel cell polyomavirus (MCPyV), there has been a rapid increase in the understanding of the carcinomas genetics, molecular biology and pathogenesis. In our study, we reviewed recent advances and controversies concerning MCC histogenesis, epidemiology, diagnostic and prognostic markers. We analyzed the association of MCPyV with MCC and the possible new targets for therapy. We also examined English-based literature regarding MCC pathogenesis published between 2008 and 2013, which lead to a deeper understanding of the topic. Our study showed that the association of MCPyV strongly influences the course of MCC. Additionally, it has been shown that a immunological response to MCPyV may in the future give hope to identify new therapeutic strategies in treatment of this fatal malignancy. This article is part of a Directed Issue entitled: Rare Cancers.
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