Total Spontaneous Regression of Advanced Merkel Cell Carcinoma after Biopsy: Review and a New Case

Richetta, Antonio Giovanni; Mancini, Monica; Torroni, Andrea; Lorè, B; Iannetti, Giorgio; Sardella, Barbara; Calvieri, Stefano

doi:10.1111/j.1524-4725.2008.34153.x

Cited by 38 publications

(43 citation statements)

References 24 publications

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“…Taken together, these findings suggest that tumor infiltrating lymphocytes might reduce the rate of metastasis more than the rate of tumor cell proliferation. The immune response may sometimes greatly influence progression of MCC, as several case reports describe MCCs that regressed spontaneously probably due to a local inflammation reaction in the tumor (21)(22)(23)(24)(25)(26). Yet, such responses are not robust enough in most cases to prevent tumor growth.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tumor Infiltrating Immune Cells and Outcome of Merkel Cell Carcinoma: A Population-Based Study

Sihto

Böhling

Kavola

et al. 2012

Clinical Cancer Research

131

129

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Section: Discussionmentioning

confidence: 99%

“…MCC may rarely (<2%) regress spontaneously or following mechanical or chemical irritation, suggesting a potential therapeutic role for the immune system modulating approaches (21)(22)(23)(24)(25)(26). Presence of lymphocytic infiltration (27,28) …”

Section: Introductionmentioning

confidence: 99%

Tumor Infiltrating Immune Cells and Outcome of Merkel Cell Carcinoma: A Population-Based Study

Sihto

Böhling

Kavola

et al. 2012

Clinical Cancer Research

131

129

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“…Regression of cutaneous Merkel cell carcinoma and nodal metastasis has rarely been reported, mostly after either surgical excision or needle biopsy of the primary lesion; and it was thought to be due to the procedures, which stimulated cell-mediated immune clearance of the residual tumor cells. [36][37][38][39][40][41][42][43][44] It is difficult to envision the spontaneous resolution of cutaneous Merkel cell carcinoma without prior medical intervention in all of our cases; moreover, it is very unlikely that all the primary tumors would have regressed without leaving any visible remnants. Therefore, we speculate that some of our nodal cases may represent primary nodal neoplasms.…”

Section: Possible Histogenesis Of Nodal Merkel Cell Carcinomamentioning

confidence: 99%

Merkel cell carcinoma of lymph node with unknown primary has a significantly lower association with Merkel cell polyomavirus than its cutaneous counterpart

Pan

Chen

et al. 2014

Modern Pathology

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Rare cases of Merkel cell carcinoma have been encountered in lymph nodes with unknown extranodal primary, which exhibit similar morphologic and immunophenotypic features to those in primary cutaneous Merkel cell carcinomas. However, it is uncertain whether the nodal Merkel cell carcinoma is a primary tumor of the lymph node or represents a metastasis from an occult or regressed extranodal lesion. To establish an accurate diagnosis of the nodal Merkel cell carcinoma can be challenging because of significant morphologic mimics, including lymphoblastic lymphoma and metastatic small cell carcinoma. Moreover, there is no consensus for a diagnostic term, and many different terms have been used, which can be confusing and may not fully reflect the nature of nodal Merkel cell carcinoma. In this study, we investigated the detailed clinicopathologic features of 22 nodal Merkel cell carcinomas, with comparison to 763 primary cutaneous cases retrieved from the literature. Overall, the nodal and cutaneous Merkel cell carcinomas shared similar clinical presentations, morphologic spectrum, and immunophenotype; both were mostly seen in elderly male with a typical neuroendocrine morphology. Most of cases expressed CK20, synaptophysin, and chromogranin A; and PAX5 and TdT were also positive in majority of cases. However, nodal Merkel cell carcinomas had a significantly lower association with Merkel cell polyomavirus than cutaneous cases (31% vs 76%, P ¼ 0.001). Therefore, these two entities may arise from overlapping but not identical biological pathways. We also recommend the use of the diagnostic term 'Merkel cell carcinoma of lymph node' to replace many other names used.

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“…3,4 The underlying mechanism for this occurrence isunclear but there is scarce evidence suggesting a relevant role of T-cell mediated immune response. 3,4 The review of previous reports in the literature is summarized in Table 1. The presence of Merkel cell polyomavirus was analysed in only few previous reports and the DNA of the virus was found in three out of four cases.…”

Section: Discussionmentioning

confidence: 99%

“…1 Spontaneous regression is a very rare occurrence in Merkel cell carcinoma with very few cases reported so far, none of them in Portugal. [2][3][4][5][6] CASE REPORT An 89-year-old woman, Fitzpatrick phototype III, farmer during 40 years andwith no relevant past medical history was observed with a rapidly-growing nodule (evolution of 3 months) with 3 cm in the left nasal ala. Histopathological examination of a skin biopsy specimen revealed a tumour composed by medium-sized cells with scant cytoplasm and hyperchromatic nucleus. Focal necrosis and frequent mitosis were also observed.…”

Section: Introductionmentioning

confidence: 99%

Carcinoma Avançado de Células de Merkel: Um Novo Caso de Regressão Espontânea

Guiote

Cunha

Pinho

et al. 2018

SPDV

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RESUMO -O carcinoma de células de Merkel é uma neoplasia cutânea agressiva que afecta predominantemente indivíduos idosos ou imunodeprimidos. A progressão para doença metastática é frequente, enquanto a regressão espontãnea é bastante rara. A exposição crónica à radiação solar e a infecção pelo poliomavírus das células de Merkel são reconhecidos factores etiopatogénicos. Uma mulher de 89 anos foi observada com um carcinoma de células de Merkel localmente avançado na asa esquerda do nariz. Tinha doença ganglionar metastática na região submandibular clinicamente evidente, confirmada por punção aspirativa com agulha fina. Uma metástase hepatica isolada foi detectada por estudo tomográfico por emissão de positrões com (68)Ga-DOTATOC. Enquanto aguardava por radioterapia paliativa, observou-se regressão do tumor primário e das metástases ganglionares, clinicamente completa ao fim de 6 semanas. Uma ecografia hepática demonstrou regressão concomitante da metástase hepatica. Os relatos de regressão espontânea de carcinoma de Merkel são muito escassos na literatura. Após a revisão realizada pelos autores, este é o primeiro caso descrito em Portugal. O mecanismo subjacente à remissão espontânea é desconhecido, embora possa ser teioricamente explicado pelo desenvolvimento de uma resposta immune eficaz contra o tumor. PALAVRAS-CHAVE -Carcinoma de Células de Merkel; Idoso; Regressão Neoplásica Espontânea. (68) Advanced Merkel Cell Carcinoma: A New Case of Spontaneous Regression ABSTRACT -Merkel cell carcinoma is an aggressive skin neoplasm affecting predominantly older or immunosuppressed patients. The progression to metastatic disease is frequent while spontaneous regression is quite uncommon. Chronic sun exposure and infection by Merkel cell polyomavirus are known etiopathogenic factors. An 89-year-old female was observed with a locally advanced Merkel cell carcinoma of the left nasal ala. Lymph node metastases in left submandibular region were clinically apparent and confirmed by fine-needle aspiration. A solitary metastasis in the liver was identified by positron-emission tomography/computed tomography with

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Total Spontaneous Regression of Advanced Merkel Cell Carcinoma after Biopsy: Review and a New Case

Cited by 38 publications

References 24 publications

Tumor Infiltrating Immune Cells and Outcome of Merkel Cell Carcinoma: A Population-Based Study

Tumor Infiltrating Immune Cells and Outcome of Merkel Cell Carcinoma: A Population-Based Study

Merkel cell carcinoma of lymph node with unknown primary has a significantly lower association with Merkel cell polyomavirus than its cutaneous counterpart

Carcinoma Avançado de Células de Merkel: Um Novo Caso de Regressão Espontânea

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