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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical and pathological features of 14 cases of Merkel cell carcinoma are reported. They commonly arise in the skin of elderly patients, particularly on the face and pelvis. They have a loco-regional aggressivity (nodal metastases in 4 cases) but some patients die with disseminated metastases (2 cases). These tumors are composed of round cells with scanty cytoplasm, arranged in solid or trabecular sheets. Mitotic figures are usually numerous. The ultrastructural study reveal secretory granules and paranuclear collection of intermediate filaments. Immunohistochemical phenotype is highly characteristic: cytoplasmic diffuse positivity with an anti-neuron-specific enolase polyclonal antibody; polar and/or diffuse positivity with anti-cytokeratin, anti-epithelial membrane antigen and anti-S100 protein monoclonal antibodies; polar positivity with an anti-neurofilament monoclonal antibody. The negativity with an anti-common leucocyte antigen monoclonal antibody is helpful to differentiate Merkel cell carcinoma from cutaneous malignant lymphoma.
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PMID:[Merkel cell carcinoma of the skin. Anatomoclinical, ultrastructural and immunohistochemical study of 14 cases]. 390 47

Four new patients with trabecular (Merkel cell) carcinoma of the skin are described, and an additional 76 patients from the literature are reviewed. The mean age of the combined group of patients was 68; 84% were 60 years or older. Primary tumors appeared most frequently on the head and neck (44%), leg (28%), arm (16%), or buttock (9%). No primary tumor appeared on the trunk. The rate of local recurrence was 36%, regional metastatic disease, 53%; distant metastases, 28%; and death due to metastatic tumor (minimally), 25%. It appears that trabecular carcinoma of the skin is more aggressive and lethal than previously thought. The authors recommend that patients with this tumor undergo wide resection of the primary site and, in healthy patients, prophylactic regional node dissection. Both radiation therapy and chemotherapy are effective in palliating unresectable disease.
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PMID:Trabecular (Merkel cell) carcinoma of the skin. Treatment of primary, recurrent, and metastatic disease. 394 Jun 17

The histologic features of the Merkel cell and the pathologic characteristics of the Merkel cell tumor are described. From a literature review, 68 cases are examined; 23 cases that have been followed up accurately are presented from the Mayo Clinic. A representative case is used to demonstrate the problems of diagnosis and suggested treatment. The latter should be wide local resection with removal of nodal metastases if present. When indicated, this should be followed up with radiation therapy. Chemotherapy is of little or no value. Survival rates are presented.
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PMID:Merkel cell tumor: diagnosis, prognosis, and management. 395 19

Merkel cell carcinoma, first reported as "trabecular carcinoma" by Toker in 1972, is a dangerous, often fatal primary skin tumor. The current authors report eight patients, only one of whom is considered to have a totally successful clinical outcome. Two patients died and one was preterminal with widespread disease in 10 to 20 months. Two others had recurrence or metastases within a year, and two patients died early of intercurrent disease after first developing regional lymph node involvement. Review of 139 patients reported in the literature indicates local recurrence in 30 per cent, regional lymph node metastases in 50 per cent, and death from neoplasm in 18 per of the cases. All patients in the present series received radiation therapy with encouraging response. The tumor was quite radiosensitive, and in only one instance was there recurrence within an irradiated field. Wide surgical excision with prompt postoperative irradiation to the local site and regional lymphatics is the therapy of choice in early lesions. Regional lymphadenectomy is recommended whenever nodal involvement is suspected. Currently, an aggressive combined surgical and radio-therapeutic approach to this dangerous neoplasm appears warranted, although further data may show that early and routine use of radiotherapy in Merkel cell carcinoma could obviate the necessity for extensive operative procedures.
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PMID:Merkel cell carcinoma: combined surgery and radiation therapy. 395 63

Trabecular cell carcinoma, originally described by Toker, is a malignant skin tumor, probably of Merkel cell origin. These tumors are locally aggressive and may metastasize. Prompt surgical removal is mandatory. The clinical features are often not diagnostic, and diagnosis is primarily by histologic examination. Special studies, especially electron microscopy, may be required to differentiate this tumor from others. During surgery, particularly with Mohs microscopically controlled excision, provision must be made for proper handling of the specimen so that these special studies can be carried out.
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PMID:Merkel cell carcinoma--a problem with microscopically controlled surgery. 395 10

This report demonstrates that hepatic metastases can present with fulminant hepatic failure and that liver enzyme abnormalities may not become prominent until there has been massive replacement of the liver. The CT scan of liver may not demonstrate diffuse liver metastases as seen in this patient. Merkel cell tumor or trabecular neuroendocrine skin tumor is a previously unreported cause for the development of the syndrome of hepatic failure due to liver metastases.
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PMID:Merkel cell tumor with liver metastases: presentation as fulminant hepatic failure. 399 38

The authors describe the clinical and histologic findings in a case of Merkel cell carcinoma of the vulva, which was associated with squamous cell carcinoma in situ and lichen sclerosus. Electron microscopy of the tumor revealed membrane-bound granules. At postmortem examination, metastases from this primary skin tumor were found in the pelvic lymph nodes, in paraortic lymph nodes, in the liver, and in vertebral bodies. The case is unusual because Merkel cell tumors are usually found on the face or the extremities and seldom metastasize widely.
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PMID:Merkel cell carcinoma of the vulva. 632 75

Primary neuroendocrine carcinoma of the skin (Merkel's cell carcinoma) is a rare tumor. Until recently 86 patients with this tumor have been described. Two cases of this tumor are presented. This neoplasm has a high propensity for lymphatic as well as hematogenous metastases. It presents as a dermal or subcutaneous nodule. Awareness of this condition may lead to earlier diagnosis and improved survival.
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PMID:Primary neuroendocrine carcinoma of the skin (Merkel's cell carcinoma). 648 49

Merkel cell carcinoma, also known as endocrine carcinoma of the skin, is a recently recognized and particularly aggressive form of skin cancer that exhibits histologic features similar to those of endocrine malignant neoplasms arising from other tissues. Forty-one patients with Merkel cell carcinoma arising from the cutaneous surfaces of the head and neck were seen at the University of Texas M. D. Anderson Hospital, Houston, between 1966 and 1983. Regional lymph node metastasis occur early and frequently, with a 79% overall incidence observed during the course of the disease. Treatment should consist of a wide resection of the primary tumor. A regional lymphadenectomy, when feasible, is successful in controlling nodal metastases. Postoperative radiation is recommended as an important adjuvant.
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PMID:Merkel cell carcinoma (endocrine carcinoma of the skin) of the head and neck. 648 23

A case of neuroendocrine carcinoma (Merkel cell tumor) of the skin in a 76 years old woman is reported. The lesion, an erythematous nodule, 2 to 3 cm in diameter occurred on the face. Light microscopic examination showed sheets of indifferentiated cells that had a uniform round nucleus and scanty cytoplasm containing argyrophil granules. An ultrastructural study demonstrated neurosecretory type granules in the cytoplasm of the tumor cells. Immunocytochemical analysis was strongly positive for neuron specific enolase, but negative for Met-Enkephalin. This case is discussed in the light of a review of 73 cases already published in the literature. The origin of the cells involved in this tumor is still discussed. Several authors have suggested that this tumor is an Apudoma possibly arising from Merkel cells. In most cases, the lesion is an erythematous nodule. The most common localization is the face (45 p. 100). The tumor can be diagnosed by routine histology, but silver staining and electron microscopic study are often helpful. Removal of the tumor should be performed. This tumor appears to be of a low grade malignancy. Local recurrences or metastases have been reported in a few cases.
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PMID:[Cutaneous neuroendocrine carcinoma : apropos of a case]. 663 82


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