Lymph Node Metastasis With Both Components of Combined Cutaneous Squamous Cell Carcinoma/Merkel Cell (Neuroendocrine) Carcinoma

Navarrete, Jorge; Gugelmeier, Natalia; Mazzei, María Eugenia; González, Sergio; Barcia, Juan J.; Magliano, Julio

doi:10.1097/dad.0000000000000927

Cited by 7 publications

(10 citation statements)

References 11 publications

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“…Although the exact pathogenesis of these combined tumors is still unknown, it appears that they represent a distinct disease process from pure MCC, as they are mostly MCPyV negative, and appear to show a more aggressive behavior 3–5,8,10,11 . Moreover, two recent case reports have demonstrated the presence of both neuroendocrine and squamous components in nodal metastases of combined MCC and SCC tumors, probably pointing to a common precursor cell 12–14 . We present two additional cases of combined MCC and SCC with nodal metastases in which both cellular lineages were present, both in the primary tumor and in the metastasis.…”

Section: Introductionmentioning

confidence: 78%

“…On the other hand, Martin et al considered their combined MCC and SCC cases as tumors derived from a common precursor cell with divergent differentiation, their pathogenesis being unrelated to MCPyV 3 . Finally, Navarrete et al do not come to any conclusion regarding the origin of the neuroendocrine and squamous elements of these tumors, but they do highlight that it is unrelated to MCPyV infection 12 . Indeed, most studies exploring the potential pathogenesis of combined MCC and SCC tumors found that, other than a few exceptions, 17–19 most of these neoplasms showed negative results for MCPyV expression, both with PCR analysis and immunohistochemical studies 1,3,15 .…”

Section: Discussionmentioning

confidence: 99%

“…3 Finally, Navarrete et al do not come to any conclusion regarding the origin of the neuroendocrine and squamous elements of these tumors, but they do highlight that it is unrelated to MCPyV infection. 12 Indeed, most studies exploring the potential pathogenesis of combined MCC and SCC tumors found that, other than a few exceptions, [17][18][19] most of these neoplasms showed negative results for MCPyV expression, both with PCR analysis and immunohistochemical studies. 1,3,15 Furthermore, a study that compared the next generation sequencing profiles of five combined MCC and SCC cases with those of seven pure MCC tumors reported that combined neoplasms had up to 38 times more singlenucleotide polymorphisms, as well as up to 48 more mutations per megabase, and frequent Rb protein, p53, NOTCH1, and ERBB4 mutations.…”

Section: Casementioning

confidence: 99%

“…[3][4][5]8,10,11 Moreover, two recent case reports have demonstrated the presence of both neuroendocrine and squamous components in nodal metastases of combined MCC and SCC tumors, probably pointing to a common precursor cell. [12][13][14] We present two additional cases of combined MCC and SCC with nodal metastases in which both cellular lineages were present, both in the primary tumor and in the metastasis. Interestingly, one of them was MCPyV negative, while the other case was found to be MCPyV positive.…”

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confidence: 95%

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Combined Merkel cell carcinoma and cutaneous squamous cell carcinoma with lymph node metastases: Report of two cases

et al. 2022

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Merkel cell carcinoma (MCC) is an infrequent, aggressive cutaneous neoplasm, that typically affects the photodamaged skin of elderly individuals, and immunosuppressed patients. Because a subset of MCC is closely related to UV radiation, MCC can develop concurrently with other tumors, most commonly, as a combined tumor with squamous cell carcinoma (SCC). These combined tumors appear to represent a distinct disease process from pure MCC, as they are mostly Merkel cell polyomavirus (MCPyV) negative, and show a more aggressive behavior. We present two additional cases of combined MCC and SCC with nodal metastases, one of which was MCPyV positive. Two different subtypes of MCC have been proposed based on their origin: a true neuroendocrine carcinoma, that is MCPyV positive and has a dermal origin, and a UV-related SCC with neuroendocrine differentiation. This theory could explain why MCC can develop concurrently with SCC, and why these combined cases are generally MCPyV negative. However, it fails to explain the minority of combined MCC and SCC tumors that are MCPyV positive. Because both our patients had a history of chronic UV exposure, we hypothesize that UV radiation probably played a major role in the pathogenesis of these tumors, while MCPyV integration probably acted as an additional trigger.combined Merkel cell carcinoma, combined Merkel cell carcinoma and squamous cell carcinoma, Merkel cell carcinoma, Merkel cell polyomavirus, nodal metastasis, squamous cell carcinoma | INTRODUCTIONMerkel cell carcinoma (MCC), also known as primary cutaneous neuroendocrine tumor, is an infrequent, aggressive cutaneous neoplasm, that typically affects the photodamaged skin of elderly individuals, and patients with a history of immunosuppression. [1][2][3][4][5][6] Although the histogenesis of MCC has been the object of considerable debate since its original description, and the cell of origin is still unknown, two distinct subtypes of MCC have now been proposed based on their pathogenesis: one that is related to the Merkel cell polyomavirus (MCPyV), that represents the majority of all cases (with variable percentages, estimated at 80% based on some studies), hypothesized to be of possible dermal (fibroblastic) origin, and another one unrelated to MCPyV infection, that appears to be caused by UV radiation, considered to be of probable epidermal origin (keratinocytic). 1,2,[7][8][9] Because a significant subset of MCC is closely related to UV radiation, it is not unusual for this tumor to be found in close association (as a collision tumor) to other UV-related neoplasms, and this has been reported in the literature with variable frequency. On the other hand, combined MCC tumors (MCC that differentiating into other neoplasms, sharing a

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Section: Introductionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Casementioning

confidence: 99%

mentioning

confidence: 95%

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Combined Merkel cell carcinoma and cutaneous squamous cell carcinoma with lymph node metastases: Report of two cases

et al. 2022

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“…Con sospecha de CCE combinado con CCM se realizó inmunohistoquímica, que confirmó el diagnóstico. Clínicamente, estos tumores son difíciles de sospechar, siendo la biopsia por punch en ocasiones insuficiente para evidenciar el sector de CCM que generalmente se encuentra más profundo en la dermis (30) .…”

Section: Discussionunclassified

Comparación histopatológica entre biopsia preoperatoria y debulking luego de la cirugía micrográfica de Mohs en carcinomas cutáneos

2022

RMY

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Objetivos: comparar los resultados histopatológicos entre la biopsia incisional y el debulking en los carcinomas cutáneos tratados con CMM en el Servicio de Dermatología del Hospital de Clínicas en el período de noviembre de 2013 a marzo de 2019.Metodología: estudio retrospectivo descriptivo, se analizaron 202 pacientes con carcinomas de piel no melanoma (CPNM) sometidos a CMM en el servicio de Cirugía Dermatológica del Hospital de Clínicas "Dr. Manuel Quintela" entre noviembre de 2013 y marzo de 2019.Resultados: únicamente se consideran los casos donde en el debulking se halló tumor. Del total, la biopsia coincidió con el debulking en 61,39% de los casos. El debulking mostró un subtipo agresivo que no fue detectado en la biopsia en 8,41% de los casos.Conclusiones: el estudio histopatológico del debulking ha demostrado ser relevante, siendo la biopsia incisional parcialmente representativa para determinar el subtipo histopatológico de un CPNM, ya que aproximadamente 1 de cada 10 carcinomas podrían ser subdiagnosticados y tratados de manera insuficiente.

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Morphological patterns of metastases from combined Merkel cell carcinomas: study of an eastern Canadian cohort of cases

Gruchy¹,

Pasternak²,

Ly³

et al. 2022

Human Pathology

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Lymph Node Metastasis With Both Components of Combined Cutaneous Squamous Cell Carcinoma/Merkel Cell (Neuroendocrine) Carcinoma

Cited by 7 publications

References 11 publications

Combined Merkel cell carcinoma and cutaneous squamous cell carcinoma with lymph node metastases: Report of two cases

Combined Merkel cell carcinoma and cutaneous squamous cell carcinoma with lymph node metastases: Report of two cases

Comparación histopatológica entre biopsia preoperatoria y debulking luego de la cirugía micrográfica de Mohs en carcinomas cutáneos

Morphological patterns of metastases from combined Merkel cell carcinomas: study of an eastern Canadian cohort of cases

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