Pyogenic Granuloma or?? Beyond the Naked Eye: Merkel Cell Carcinoma; Case Report and Literature Review

Charandeep Singh and Fuad Aftab

Department of General Surgery, Mallow General Hospital, Ireland

^*Correspondance to: Charandeep Singh 

 PDF  Full Text DOI: 10.25107/2474-1647.1206

Abstract

Introduction: Merkel cell carcinoma (MCC) is a rare and highly aggressive primary cutaneous neuroendocrine carcinoma, most often occurring at an elderly age group. Recurrence is frequent and in 40% of cases regional and distant metastases develop. We report the case of excision of MCC in a 85-year-old woman followed by wide excision and sentinel lymph node biopsy.Case
Presentation: An 85-year-old woman presented to surgical out-patient clinic with a firm fleshy, protuberant lump on the superior margin of right zygomatic area of face measuring 20 x 20mm, approximately. She was under investigation for Iron Deficiency Anemia along with high WBC. The lesion was excised under local anesthesia and immunohistochemistry confirmed diagnosis of MCC. Upon histological confirmation of diagnosis, the patient underwent further staging, to exclude regional and distant metastasis, including CT scan of the neck and TAP. Further treatment included wide local excision and sentinel lymph node mapping.
Discussion: MCC is rare carcinoma with very few known causes. Immune suppression is proposed as an etiological factor. Surgery has a major role with radiotherapy and chemotherapy playing their roles for palliation.Conclusion: MCC is very aggressive cutaneous carcinoma with poor prognosis and high mortality rate, with life expectancy of 8-10 months from the time of distant diagnosis. Radiotherapy has a role but surgery still is the Gold Standard. Due to rarity of this disease, we feel that these patients need to be under strict follow-up program.

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Cite the article

Singh C, Aftab F. Pyogenic Granuloma or?? Beyond the Naked Eye: Merkel Cell Carcinoma; Case Report and Literature Review. Clin Surg. 2016; 1: 1206.