DermatopathologyEpidermotropic Merkel cell carcinoma: A case series with histopathologic examination
Section snippets
Immunohistochemical stains
The immunohistochemical stains on all samples included cytokeratin (CK)-20 dilution: 1:40, clone KS20.8 (Dako North America Inc, Carpenteria, CA); thyroid transcription factor (TTF)-1, dilution: 1:100, clone 8G7G3/1 (Dako North America Inc); epithelial membrane antigen (EMA), dilution: 1:1000, clone E29 (Dako North America Inc); chromogranin, dilution: 1:40, clone LK2H10 (Signet Laboratories, Dedham, MA); and neuron-specific enolase, dilution: 1:100, clone N3 (MIG-N3) (Biogenex Laboratories,
Case reports
The patients were 5 men and one woman whose ages ranged from 72 to 92 years (mean age, 82.5 years). The patients presented with clinical cutaneous changes (Table I) and supportive histopathologic findings (Table II) that led to a diagnosis of epidermotropic MCC.
Immunohistochemical staining
The relative staining patterns of the tumors with each of the immunohistochemical stains, and the percentage of the tumor positively staining, are described in Table II.
CK20 and EMA staining patterns
In cases 1, 3, and 6, the perinuclear dot pattern observed with CK20 in the epidermotropic MCC cells was less pronounced than the pattern observed in the dermis, whereas in the remaining cases there was no significant difference in staining pattern observed. In all 6 tumors, the staining pattern observed with EMA was identical
Discussion
MCC is the second most common cause of nonmelanoma skin cancer death in the United States and has a 5-year overall survival of 75%, 59%, and 25% for local, regional, and distant metastases, respectively. Incidence is estimated at 0.44 cases per 100,000, and is increasing at about 8% per year.1, 2 It is also possible that there is an increase in the incidence of diagnosis as opposed to a true increase in incidence because more is known today about how to diagnose the neoplasm.
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Cited by (21)
Update on Merkel Cell Carcinoma: Epidemiology, Etiopathogenesis, Clinical Features, Diagnosis, and Staging
2017, Actas Dermo-SifiliograficasMerkel cell carcinoma - Recent advances in the biology, diagnostics and treatment
2014, International Journal of Biochemistry and Cell BiologyCitation Excerpt :Merkel cells are localized in the epidermis (Moll et al., 2005) while MCC usually develops in the dermis and subcutis, mostly sparing the epidermis. Epidermotropism was identified in approximately 15% of cases analyzed (D’Agostino et al., 2010). However incipient, very small and early MCCs can be located both at the epidermal junction as well as in hypodermis, close to the subcutaneous adipose tissue (Requena et al., 2013).
Merkel cell carcinoma of the eyelid: A review
2019, Survey of OphthalmologyCitation Excerpt :Although the face is often affected, eyelid tumors represent only 2.5% of cases.74 To date, there have been approximately 200 cases of eyelid MCC reported, the features of which are summarized in Table 1.5–7,10,12,14–18,20,21,25–27,30,32–34,36,38,40,44,46–50,52,53,58,66,68–71,75,77,81–83,86,88,90,92–95,97,98,100,101,103–107,109–112,116–118,120–122,124,125,128–130,133,134,136,137,140,141 Although the pathogenesis of MCC is incompletely understood, the Merkel cell polyomavirus (MCPyV) plays a major role, along with UV exposure and immunosuppression.
Merkel Cell Hyperplasia Versus Intraepidermal Merkel Cell Carcinoma: A Comparative Study of 2 Cases
2023, American Journal of DermatopathologyPagetoid Spread in Basal Cell Carcinoma: Potential for Misdiagnosis
2023, American Journal of Dermatopathology
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Conflicts of interest: None declared.
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