Lymph node metastasis of Merkel cell carcinoma without known cutaneous primary - case report

Authors: Arpád Szabó 1;  Igor Richter 2,7;  Dana Frydrychová 3;  Martina Saláková 4,5;  Tomáš Jirásek 1,6
Authors‘ workplace: Ústav patologie 3. LF UK a Fakultní nemocnice Královské Vinohrady, Praha 1;  Komplexní onkologické centrum, Krajská nemocnice Liberec, a. s. 2;  Kožní oddělení, Krajská nemocnice Liberec, a. s. 3;  Národní referenční laboratoř pro papilomaviry a polyomaviry, Ústav hematologie a krevní transfuze, Praha. 4;  Katedra genetiky a mikrobiologie, Přírodovědecká fakulta, Univerzita Karlova, Praha 5;  Oddělení patologie, Krajská nemocnice Liberec, a. s. 6;  Onkologická klinika 1. LF UK a Thomayerovy nemocnice, Praha 7
Published in: Čes.-slov. Patol., 53, 2017, No. 3, p. 135-138
Category: Original Article


Merkel cell carcinoma is a rare cutaneous tumor with an aggressive clinical course. In most cases it is associated with Merkel cell polyomavirus infection. Exceptionally, the tumor can present as a lymph node metastasis without a discernible cutaneous primary.

In this report we present the case of a 42 year-old man with inguinal lymphadenopathy, histologically consistent with Merkel cell carcinoma. Tumor cells expressed immunohistochemically chromogranin-A, synaptophysin and displayed dot-like positivity for cytokeratin 20. The genome of MCPyV in neoplastic cells was detected using real-time PCR. A cutaneous primary has not been identified neither during the dermatologic examination, nor with PET CT scan.

Merkel cell carcinoma – lymph node metastasis – tumor of unknown primary origin


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