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de Carvalho Kimura T, Takahiro Chone C, Augustin Vargas P, Said Abu Egal E, Altemani A, Viviane Mariano F. Exploring diagnosis and therapeutic complexities of an aggressive Merkel cell carcinoma: A case report and review of the literature. Oral Oncol 2023; 147:106603. [PMID: 37879149 DOI: 10.1016/j.oraloncology.2023.106603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/27/2023]
Abstract
Merkel cell carcinoma (MCC) is an aggressive and rare cutaneous neuroendocrine carcinoma that predominantly affects the sun-damaged skin of the head and neck region, extremities, and trunk of older white individuals. Microscopically, MCC is characterized by nests or sheets of uniform small round blue cells with scant cytoplasm, granular nuclei with a salt-and-pepper chromatin pattern, high proliferative activity, and occasional necrosis. They are usually positive for epithelial and neuroendocrine markers, particularly for cytokeratin 20 and AE1/AE3 in a paranuclear dot-like staining. We herein contribute by reporting a case of MCC affecting the auricular pavilion of a 66-year-old female patient from Campinas, Brazil. Additionally, a review of the current literature is also included to analyze all the cases that have been reported in the English-language literature, totalizing 27 cases of MCC on the external ear. The 5-year overall survival rate for individuals with localized MCC is 50% and the most common treatment choice is the combination of surgery with adjuvant radiotherapy and sentinel lymph node biopsy.
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Affiliation(s)
- Talita de Carvalho Kimura
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Department of Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Carlos Takahiro Chone
- Ophthalmology and Otorhinolaryngology Department, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Pablo Augustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Erika Said Abu Egal
- Biorepository and Molecular Pathology, Huntsman Cancer Institute, University of Utah (UU), Salt Lake City, UT, United States
| | - Albina Altemani
- Department of Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Fernanda Viviane Mariano
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Department of Pathology, School of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
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Merkel cell carcinoma of the auricle. J Craniofac Surg 2014; 25:2266-8. [PMID: 25347599 DOI: 10.1097/scs.0000000000001155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Gioacchini FM, Postacchini V, Simonetti O, Offidani A, Magliulo G, Re M. Merkel cell carcinoma: a systematic review of ENT presentations. Eur Arch Otorhinolaryngol 2012. [PMID: 23192664 DOI: 10.1007/s00405-012-2283-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to perform a systematic literature review of Merkel cell carcinomas (MCCs) originating exclusively in the ear, nose and throat (ENT) district. An appropriate string was run on PubMed to retrieve articles dealing with ENT presentations of MCC. A double cross-check was performed on citations and full-text articles found using the selected inclusion and exclusion criteria. In total, 43 articles were finally included in the study, describing 51 cases of MCC involving the ENT region: 22/51 (43%) cases involving the ear; 20/51 (39%) cases involving the mucosal sites; 9/51 (18%) cases involving other ENT regions. Patients with mucosal site involvement showed a higher mortality rate from the disease (45%) in comparison with the other two groups, especially when compared with those patients having primary involvement of the ear (22%). The ENT specialist should suspect and consider MCC, especially in elderly patients presenting with a suspicious lesion of the auricular pavilion, so as to avoid misdiagnosis and delayed treatments.
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