Merkel Cell Carcinoma with Gastric Metastasis, a Rare Presentation: Case Report and Literature Review

Abstract

Merkel cell carcinoma (MCC) is an infrequent, but highly aggressive neuroendocrine neoplasm of the skin with a propensity for recurrence and metastasis. We report a rare case of gastric metastatic localization of this cancer by focusing on the diagnostic, clinical and surgical approach to the patient. Case report.Clinical presentation begins with a peripheral lymphadenopathy whose immunohistochemical characterization identi es the lymphatic dissemination of the disease. Gradually the patient develops a severe anaemic state which requires several blood transfusions and surgical gastric resection to remove a large bleeding lesion of the antral region. The histopathological analysis of the specimen con rms the metastatic origin from MCC, but the primitive lesion remains unknown. Discussion.Since this clinical situation is very rare, we conducted a review of the literature selecting the few cases reported, in order to evaluate the current knowledge on this topic. Metastatic involvement of the stomach from Merkel cell carcinoma is a rare presentation of this disease progression with a frequent delay in formulating the correct diagnosis and in further treatment which may be life-threatening for the patient. As regards the local treatment, there is no speci c guideline, and the therapeutic indication should be tailored on the speci c case.