Recurrent and metastatic cutaneous neuroendocrine (Merkel cell) carcinoma mimicking angiosarcoma
S. K. Tyring, P. C. Lee, E. F. Omura, L. K. Green and Y. Merot
Department of Dermatology, University of Alabama at Birmingham.
An elderly man presented with bright red-to-purple confluent nodules and
plaques of the scalp that appeared clinically consistent with angiosarcoma.
He had undergone surgical removal of a similar lesion from his left temple
seven months before this presentation. Although routine histologic
examination was not sufficient for diagnosis, Merkel cell carcinoma was
diagnosed by immunohistochemical studies and electron microscopy. In
addition, oat cell carcinoma of the lung was excluded with a computed
tomographic scan of his chest. With chemotherapy, the recurrent and
metastatic lesions of Merkel cell carcinoma completely resolved, rapidly
recurred, and resolved a second time with chemotherapy. Eight months
following the fourth course of chemotherapy, the patient again developed
widespread cutaneous lesions. He committed suicide within one month of this
last recurrence. An autopsy revealed no primary tumor other than of the
skin.
