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Arch Dermatol. 2004;140:609-614.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Merkel cell carcinoma (MCC).

MICROSCOPIC FINDINGS AND CLINICAL COURSE

Microscopic examination showed a large tumor composed of poorly differentiated, small, round, blue cells that were arranged in a rosette pattern in some areas. Numerous mitotic figures were present. Individual cells had scanty cytoplasm and powdery chromatin. The tumor was thought to be of neuroendocrine origin. Two diagnoses were considered: metastatic or primary oat cell carcinoma and MCC. Special stains were negative for neuron-specific enolase, chromogranin, and synaptophysin. Immunohistochemical studies were positive for cytokeratin 20 and negative for cytokeratin 7, thus confirming the diagnosis of MCC.

The patient was sent for full-body imaging studies. Radiography of his chest demonstrated no abnormalities, but a computed tomographic scan of his head and neck revealed definite invasion of the subcutaneous fat, with involvement of the deep tissues. There were several small lymph nodes bilaterally and a suspicious 8-mm, irregular, lymph node near the left parotid gland. The findings of all other computed tomographic . . . [Full Text of this Article]

DISCUSSION

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Arch Dermatol. 2004;140(5):609-614.
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