Giant Merkel Cell Carcinoma Involving the Face

YAYLI S., Tugcugil S., Alpay K., YILDIZ K., Nebioglu A., Bahadir S.

TURKDERM-ARCHIVES OF THE TURKISH DERMATOLOGY AND VENEROLOGY, vol.46, no.2, pp.98-100, 2012 (SCI-Expanded) identifier identifier


Merkel cell carcinoma is a rare, aggressive, malignant cutaneous tumor. It usually appears on the sun-exposed areas such as the head and neck in the elderly. A 72-year-old female patient was admitted to our clinic with the complaints of a big mass on her face. She described that the mass on her left cheek rapidly grew in three months. Her family and own medical history was unremarkable for skin cancers. On physical examination, there were no pathological findings except for a palpable submandibular lymphadenopathy. Dermatological examination revealed a giant tumoral lesion 9x9 cm in diameter, containing crusted and ulcerated areas on her left cheek Histopathological examination of the specimen obtained from the lesion showed a neoplastic infiltration consisting small, atypic cells with big, round, hyperchromatic nucleus, narrow cytoplasms, and prominent nucleoulus in some areas, showing high mitotic activity. The neoplasm, which had apoptotic bodies and necrobiosis, also invaded the full thickness of the skin, and the epidermis was very thin. In immunochemistry, CK20 was strongly positive, S100 was focally positive, and EMA was positive, while synaptophysin, chromogranin, vimentin, CD3, CD20, as well as CD45, and CD99 were all negative. Based on these findings, the patient was diagnosed as having Merkel cell carcinoma. On the systemic screening for metastases, nodular lesions in the lungs compatible with metastases were detected on computed tomography. By the consultations with plastic and reconstructive surgeons and oncologists, she was accepted as inoperable and etoposide monotherapy was administered. In this report, we aimed to underline the importance of early diagnosis while presenting a case of giant Merkel cell carcinoma which shows an aggressive progression with lung metastases. (Turkderm 2012; 46: 98-100)