A second field metachronous Merkel cell carcinoma of the lip and the palatine tonsil confirmed by microarray-based comparative genomic hybridisation

Abstract

Merkel cell carcinoma was diagnosed in a 79-year-old Caucasian woman. The tumour was localised to the upper lip and was in stage T2. After successful cryosurgery and a 7-year tumour-free period, a new tumour developed in her palatine tonsil. Histologically and immunohistochemically, this resembled the tumour in the lip. The regional lymph nodes were devoid of metastasis. The paraffin-embedded material of the two tumours and the unaffected lymphatic tissue were analysed with DNA microarrays for comparative genomic hybridisation to assess the genetic relationship of the tumours. In both tumours, regions on 2p and 10p were commonly over-represented, while 41 regions on chromosomes 1-4, 6, 8-9, 11 and 14-22 were commonly under-represented. Chromosomes 1, 3, 4, 16-18 and X were most frequently involved in the DNA losses. In gene copy numbers in the two tumours, 31 chromosome locations were found to be differently affected. The partly similar and partly different molecular patterns indicated a genetic relationship between the tumours and excluded the possibility that the tonsillar tumour was a metastasis. The findings suggest that a genetically altered field was the reason for the development of the tonsillar cancer; thus, it can be regarded pathogenetically as a second field tumour.

In transit Recurrence of Merkel Cell Carcinoma Associated with Polyarthritis Effectively Treated with Immunocryosurgery

“…Regarding the assessment of the therapeutic efficacy of immunocryosurgery in MCC, topical imiquimod has been evaluated in a single case of MCC in combination with radiotherapy (12) and complete remission for 7 years of a primary T2 MCC was described with cryosurgery (13). Before the observed therapeutic outcome can be ascribed to immunocryosurgery one should consider the possibility of spontaneous regression.…”

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

“…To our knowledge, there have only been 3 studies to date that have used genomic analysis to investigate the relationship between multiple cutaneous MCCs 6, 7, 8. Nagy et al 7 used aCGH to show that although MCCs of the lip and palatine tonsil, separated in time by 7 years, showed 31 distinct copy number alterations, they did not arise independently, as they shared copy number changes at 45 other chromosomal loci 7 .…”

Metachronous Merkel Cell Carcinoma on Both Cheeks

“…Kaae et al (16) reported a statistically significant increased risk of squamous cell carcinoma of the skin and chronic lymphocytic leukaemia after a diagnosis of MCC. As MCC is a rare tumour, it is unknown whether there is an increased (18). Our patient represents the first case of a metachronous MCC arising in the same organ (facial skin).…”