Partial Gastric Resection for Symptomatic Anemia following Diagnosis of Merkel Cell Carcinoma (MCC) of the Skin with Gastric Metastasis

Abstract

Merkel Cell Carcinoma (MCC) is a rare dermatologic malignancy with significant morbidity and mortality associated with metastatic disease. In this case, we discuss and extremely rare presentation of MCC with metastasis to the stomach in a patient that presented with profound anemia. Unfortunately, mortality following diagnosis of MCC with gastric metastasis approaches 67% at 4 months based on available published reports. Due to its rarity and high rate of mortality, there is a lack of available research and literature to help guide treatment of this rare presentation of MCC. This case report presents a positive outcome associated with a partial gastrectomy for the treatment of symptomatic MCC with gastric metastasis and continued survival with persistently stable hemoglobin at 12 months. Key clinical message: Anemia may be a significant cause of the morbidity and mortality associated with MCC with gastric metastasis. Our case demonstrates a positive outcome associated with partial gastric resection and presents a possible treatment option for this rare disease process.

Gastric Metastasis of Primary Neuroendocrine Tumor of Skin: Rare Tumor with Rare Presentation

“…6,7 Metastasis of MCC to the stomach is extremely uncommon and a rare presentation of disease progression; only a few case reports are available in the published literature. 4,[8][9][10][11][12][13] Due to its rarity, there may be a delay in correctly diagnosing this metastatic disease and subsequent delay in further systemic treatment. The life expectancy ranges from 1 week to 1 year with an average mortality rate of 67% at 4 months following the diagnosis of gastric metastasis.…”

“…The life expectancy ranges from 1 week to 1 year with an average mortality rate of 67% at 4 months following the diagnosis of gastric metastasis. [8][9][10][11][12][13] There is no unanimous treatment protocol for patients with GI metastasis. Primary treatment of MCC is wide resection.…”

“…The use of partial gastrectomy (wide resection preferred over radical surgery) along with radiotherapy/chemotherapy including various platinumbased drugs is controversial and very few case reports have illustrated their use. [8][9][10][11][12][13]…”