Merkel cell carcinoma of right buttock in an elderly patient: a case report

  • Shiromani Debbarma Department of Radiotherapy, Regional Institute of Medical Sciences, Lamphel, Imphal, Manipur
  • Rajesh Sharma Department of Radiotherapy, Regional Institute of Medical Sciences, Lamphel, Imphal, Manipur
  • Dhaneshor Sharma Department of Radiotherapy, Regional Institute of Medical Sciences, Lamphel, Imphal, Manipur
  • Th Tomcha Singh Department of Radiotherapy, Regional Institute of Medical Sciences, Lamphel, Imphal, Manipur
Keywords: chemotherapy, elderly patient, merkel cell carcinoma, radiotherapy
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Abstract

Merkel cell carcinoma is a rare primary cutaneous tumor. So far, few cases have been reported. Herewith we report a case of an 87-years-old male with painless, ulceroproliferative growth measuring 6x6 cm, over right upper outer quadrant of buttock; stage IIB (TNM, T3cNoMo). Patient received neo-adjuvant chemotherapy, injection of carboplatin 420 mg (day one) and etoposide 140 mg (day one to three) three weekly for three cycles followed external beam radiotherapy by Cobalt 60. At three months post-treatment follow-up, clinically no evidence of residual disease or recurrences noted. The purpose of reporting this case was to emphasize to its rarity, early asymptomatic clinical course leading to possibility of delayed diagnosis and paramount importance of high index of clinical suspicion in definitive diagnosis for better treatment result.

Author Biographies

Shiromani Debbarma, Department of Radiotherapy, Regional Institute of Medical Sciences, Lamphel, Imphal, Manipur

JUNIOR RESIDENT,

DEPARTMENT OF RADIOTHRAPY,

REGIONAL INSTITUTE OF MEDICAL SCIENCES

LAMPHEL, IMPHAL,
MANIPUR-795004
INDIA

Rajesh Sharma, Department of Radiotherapy, Regional Institute of Medical Sciences, Lamphel, Imphal, Manipur

JUNIOR RESIDENT

DEPARTMENT OF RADIOTHERAPY

RIMS, IMPHAL

INDIA

Dhaneshor Sharma, Department of Radiotherapy, Regional Institute of Medical Sciences, Lamphel, Imphal, Manipur
ASSISTANT PROFESSOR

DEPARTMENT OF RADIOTHERAPY

RIMS, IMPHAL

INDIA

Th Tomcha Singh, Department of Radiotherapy, Regional Institute of Medical Sciences, Lamphel, Imphal, Manipur

PROFESSOR

DEPARTMENT OF RADIOTHERAPY

RIMS, IMPHAL

INDIA

References

  1. Toker C. Trabecular carcinoma of the skin. Arch Dermatol. 1972;105(1):107-10. http://dx.doi.org/10.1001/archderm.105.1.107

  2. Haag ML, Glass LF, Fenske NA. Merkel cell carcinoma: diagnosis and treatment. Dermatol Surg. 1995; 21(8):669-83. http://dx.doi.org/10.1111/j.1524-4725.1995.tb00269.x

  3. Hitchcock CL, Bland KI, Laney RG 3rd, Franzini D, Harris B, Copeland EM 3rd. Neuroendocrine (merkel cell) carcinoma of the skin. Its natural history, diagnosis, and treatment. Ann Surg. 1988; 207(2):201-7. http://dx.doi.org/10.1097/00000658-198802000-00015

  4. Nghiem P, Jaimes N. Merkel cell carcinoma. In: Wolff K, Katz S, Goldsmith L, Gilchrest B, Leffell D, Paller A, editors. Fitzpatrick's dermatology in general medicine. 7th ed. USA: McGraw-Hill; 2008.

  5. Pectasides D, Pectasides M, Economopoulos T. Merkel cell cancer of skin. Ann Oncol. 2006;17(10):1489-95. http://dx.doi.org/10.1093/annonc/mdl050

  6. Dinh V, Feun L, Elgart G, Savaraj N. Merkel cell carcinomas. Hematol Oncol Clin North Am. 2007; 21(3):527-44. http://dx.doi.org/10.1016/j.hoc.2007.04.008

  7. Feng H, Shuda M, Chang Y, Moore PS. Clonal integration of a polyomavirus in human merkel cell carcinoma. Science. 2008; 319(5866):1096-100. http://dx.doi.org/10.1126/science.1152586

  8. Heath M, Jaimes N, Lemos B, Mostaghimi A, Wang LC, Pe-as PF, et al. Clinical characteristics of merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features. J Am Cad Dermatol. 2008; 58(3):375-81. http://dx.doi.org/10.1016/j.jaad.2007.11.020

  9. McAfee WJ, Morris CG, Mendenhall CM, Werning JW, Mendenhall NP, Mendenhall WM. Merkel cell carcinoma: treatment and outcomes. Cancer. 2005;104(8):1761-4. http://dx.doi.org/10.1002/cncr.21355

  10. Gorjón PS, Morales AC, Pérez PB, González JLG, de Dios JC, Melgar AR. Merkel cell carcinoma: a presentation of 5 cases and a review of the literature. Acta Otorrinolaringol Esp. 2011; 62(4):306-10. http://dx.doi.org/10.1016/j.otorri.2010.12.009

  11. Rockville Merkel Cell Carcinoma Group. Merkel cell carcinoma: recent progress and current priorities on etiology, pathogenesis, and clinical management. J Clin Oncol. 2009;27(24):4021-6. http://dx.doi.org/10.1200/JCO.2009.22.6605

  12. Eng TY, Boersma MG, Fuller CD, Cavanaugh SX, Valenzuela F, Herman TS. Treatment of merkel cell carcinoma. Am J Clin Oncol. 2004;27(5):510-5. http://dx.doi.org/10.1097/01.coc.0000135567.62750.f4

  13. Veness MJ. Merkel cell carcinoma (primary cutaneous neuroendocrine carcinoma): an overview on management. Australas J Dermatol. 2006;47(3):160-5. http://dx.doi.org/10.1111/j.1440-0960.2006.00263.x

  14. Mehrany K, Otley CC, Weenig RH, Phillips PK, Roenigk RK, Nguyen TH. A meta-analysis of the prognostic significance of sentinel lymph node status in merkel cell carcinoma. Dermatol Surg. 2002; 28(2):113-7. http://dx.doi.org/10.1046/j.1524-4725.2002.02901.x

  15. Bichakjian CK, Lowe L, Lao CD, Sandler HM, Bradford CR, Johnson TM, et al. Merkel cell carcinoma: critical review with guidelines for multidisciplinary management. Cancer. 2007; 110(1):1-12. http://dx.doi.org/10.1002/cncr.22765

  16. Boyse K, Foley EH, Bradley V, Scarborough D. Merkel cell carcinoma: a case report with treatment summary and updates. Cutis. 2004; 74:350-6.

  17. Ratner D, Nelson BR, Brown MD, Johnson TM. Merkel cell carcinoma. J Am Acad Dermatol. 1993; 29(2Pt1):143-56. http://dx.doi.org/10.1016/0190-9622(93)70159-Q

  18. Meeuwissen JA, Bourne RG, Kearsley JH. The importance of postoperative radiation therapy in the treatment of merkel cell carcinoma. Int J Radiat Oncol Biol Phys. 1995;31(2):325-31. http://dx.doi.org/10.1016/0360-3016(94)E0145-A

Published
2015-11-09
How to Cite
1.
Debbarma S, Sharma R, Sharma D, Singh TT. Merkel cell carcinoma of right buttock in an elderly patient: a case report. Med J Indones [Internet]. 2015Nov.9 [cited 2024Apr.27];24(3):190-4. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/1242
Section
Case Report/Series