Merkel cell carcinoma of the skin

Nathu, Rakesh M.; Mendenhall, William M.; Parsons, James T.

doi:10.1002/(sici)1520-6823(1998)6:5<233::aid-roi5>3.0.co;2-m

Cited by 21 publications

(13 citation statements)

References 22 publications

(46 reference statements)

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“…Radiation may be used as the only treatment especially in patients who are too weak to undergo surgical treatment [14,16]. Chemotherapy is reserved for systemic disease, though the success of this treatment is limited and no chemotherapy protocol has been shown to improve survival [15,17]. Doxorubicin/cyclophosphamide based regimen is most commonly used; the other agents include cisplatin, vincristine, etoposide, methotrexate, bleomycin.…”

Section: Discussionmentioning

confidence: 99%

Spinal extra-dural metastasis from Merkel cell carcinoma: a rare cause of paraplegia

Kamath

Venkateswaran²,

Shetty

et al. 2007

Eur Spine J

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We report a rare case of Merkel cell carcinoma with extra-dural spinal metastasis causing paraplegia. There are only four reported cases in literature. A 57-year-old lady presented with a breast lump, multiple truncal skin swellings, low back pain and rapidly progressive paraplegia. MRI showed multiple epidural soft tissue masses causing neural compression. A biopsy from the truncal skin lesion was diagnosed as Merkel cell carcinoma (MCC). Posterior decompression and tumor debulking at all three sites of neural compression was performed. Histopathology of the epidural tumor was consistent with MCC and the diagnosis was confirmed by immuno-histochemistry staining for cytokeratin-20. She was started on chemotherapy and radiotherapy. One month after diagnosis she died due to extensive metastasis. The short term palliative response seen in our patient demonstrates the poor prognosis for patients with spinal metastasis.Keywords Merkel cell carcinoma Á Spinal metastasis Á Secondaries Á Paraplegia Case reportA 57-year-old diabetic lady presented with persistent low back pain and bilateral radiculopathy of 2 months duration followed by rapidly progressive weakness and numbness of the lower limbs. She also had loss of bowel and bladder control since 1 week. Multiple painless skin lumps over the chest and abdomen had appeared spontaneously a few months prior to presentation. There were no constitutional symptoms. General examination revealed multiple firm nontender shiny skin lumps approximately 3-4 cm in diameter on the anterior abdominal wall, chest and on the right breast. There were also firm and non-tender mobile lymph-nodes of 2-3-cm size in the right posterior triangle of the neck (Fig. 1a). There was no tenderness or pain on movements of the spine. She had a flaccid paraplegia, a left extensor plantar response and sensory hypoesthesia below the ninth thoracic dermatome bilaterally. The radiographs and CT scan done prior to admission were normal (Fig. 1b, c). An MRI showed epidural soft tissue masses causing neural compression at the eighth thoracic, fourth lumbar and first sacral levels. There were also with multiple soft tissue lesions in the paraspinal and retroperitoneal space--features suggestive of metastasis. There was no history to suggest immuno-compromised status and human immunodeficiency virus infection was eliminated by the appropriate laboratory tests.An FNAC of the lymph node, anterior abdominal wall mass and right breast was reported as a small cell tumor. An incisional biopsy from a skin lesion was reported as MCC. A laminectomy and tumor debulking at all three sites of compression was performed. Epidural tumor tissue sent for histopathology was reported as a high grade malignancy composed of epitheliod cells with scanty cytoplasm, markedly pleomorphic nulei having a ''salt and pepper'' chromatin (highly reminiscent of a neuro-endocrine origin). The tumor cells with numerous mitosis were predominantly disposed in a trabercular and cribriform pattern and also arranged around necrotic space...

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Section: Discussionmentioning

confidence: 99%

Spinal extra-dural metastasis from Merkel cell carcinoma: a rare cause of paraplegia

Kamath

Venkateswaran²,

Shetty

et al. 2007

Eur Spine J

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“…Figure 1 shows the distribution of citations. References (Seymour & Mothersill 1997; Sheridan et al 1997; Desai et al 1998; Schmidt-Ullrich et al 1999; Smith & Haffty 1999; Johnson et al 1998; Monga et al 1999; Stickle et al 1999; Merrick et al 1998; Roach et al 1997; Wazer et al 1999; Joschko et al 1997; Chidel et al 1999; Durand & Olive 1997; Peschel et al 1999; Norman et al 1997; Kramer et al 1998; Leborgne et al 1997; Epperly et al 1999; Chancy et al 1998; Prete et al 1998; Fernandez-Vicioso et al 1997; Kang & Suh 1999; Banasiak et al 1999; Nathu et al 1998; Haffty et al 1997; Gieger et al 1997) and Table 1 include the 25 most frequently cited articles (all had at least 30 citations and were published in volumes 5-7, most emanated from the USA). The most frequently cited article in the first 4 volumes achieved 23 citations (Teicher et al 1996).…”

Section: Resultsmentioning

confidence: 99%

Scientific impact of studies published in temporarily available radiation oncology journals: a citation analysis

et al. 2015

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The purpose of this study was to review all articles published in two temporarily available radiation oncology journals (Radiation Oncology Investigations, Journal of Radiosurgery) in order to evaluate their scientific impact. From several potential measures of impact and relevance of research, we selected article citation rate because landmark or practice-changing research is likely to be cited frequently. The citation database Scopus was used to analyse number of citations. During the time period 1996-1999 the journal Radiation Oncology Investigations published 205 articles, which achieved a median number of 6 citations (range 0-116). However, the most frequently cited article in the first 4 volumes achieved only 23 citations. The Journal of Radiosurgery published only 31 articles, all in the year 1999, which achieved a median number of 1 citation (range 0-11). No prospective randomized studies or phase I-II collaborative group trials were published in these journals. Apparently, the Journal of Radiosurgery acquired relatively few manuscripts that were interesting and important enough to impact clinical practice. Radiation Oncology Investigations’ citation pattern was better and closer related to that reported in several previous studies focusing on the field of radiation oncology. The vast majority of articles published in temporarily available radiation oncology journals had limited clinical impact and achieved few citations. Highly influential research was unlikely to be submitted during the initial phase of establishing new radiation oncology journals.

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“…These studies are summarized in Table 1. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Most studies comprised case reports and small case series reporting different treatment modalities that also included RTx as definitive treatment.…”

Section: Literature Reviewmentioning

confidence: 99%

Role of definitive radiotherapy in treating patients with inoperable Merkel cell carcinoma: The Westmead Hospital experience and a review of the literature

Koh

Veness

2009

Aust J Dermatology

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Merkel cell carcinoma (MCC) is an uncommon aggressive primary cutaneous neuroendocrine carcinoma with a propensity to spread to regional lymph nodes and distant sites. The head and neck is the commonest site for presentation (50-60%) and recent evidence suggests patients treated with excision (to achieve a negative microscopic margin) and adjuvant wide-field radiotherapy (RTx) have an improved survival compared with surgery alone. Surgery is often not possible in elderly patients with multiple co-morbidities and in patients with advanced lesions. Definitive RTx therefore remains an option in these inoperable patients, with data to report its benefit. We report the results of eight patients with inoperable MCC treated with RTx alone between 1993 and 2007 at Westmead Hospital, Sydney, Australia, and also review the relevant literature on definitive RTx in the treatment of MCC. The median age at diagnosis was 82.5 years in five women and three men. All patients were Caucasian and none were immunosuppressed. Seven of eight patients were clinically node-positive. The mean duration of follow up was 12 months. A median dose of 50 Gy was prescribed. Seven of eight patients with inoperable MCC achieved in-field control, with most eventually relapsing distantly. Treatment-related toxicity was acceptable. In keeping with our results, other studies also report high rates of in-field locoregional control following RTx alone. These findings highlight the radioresponsiveness of advanced MCC and support a recommendation of moderate-dose RTx alone in select cases. Lower-dose palliative dose fractionation schedules (e.g. 25 Gy in five fractions) may be considered in patients of very poor performance status.

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Merkel cell carcinoma of the skin

Cited by 21 publications

References 22 publications

Spinal extra-dural metastasis from Merkel cell carcinoma: a rare cause of paraplegia

Spinal extra-dural metastasis from Merkel cell carcinoma: a rare cause of paraplegia

Scientific impact of studies published in temporarily available radiation oncology journals: a citation analysis

Role of definitive radiotherapy in treating patients with inoperable Merkel cell carcinoma: The Westmead Hospital experience and a review of the literature

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