Ottinetti A, Colombo E, Dardano F, Migliora P, Picciotto F, Zaccagna A, Angeli G
Department of Pathology, Ospedale S. Andrea, Vercelli, Italy.
J Cutan Pathol. 2003 Sep;30(8):512-5. doi: 10.1034/j.1600-0560.2003.00062.x.
Cutaneous metastasis from neuroendocrine carcinomas of visceral origin is rarely described in indexed literature. The primary sites of origin include: lung (Wick et al., J Am Acad Dermatol 1985; 13: 134), larynx (Zambruno et al., Ann Dermatol Venereol 1989; 116: 855; Schmidt et al., J Laryngol Otol 1994; 108: 272; Guerzider et al., Ann Pathol 1991; 11 (4): 253), mediastinum (Yoshimasu et al., J Dermatol 2001; 28 (3): 168), uterus (Fogaca et al., J Cutan Pathol 1993; 20: 455), and thymus (Wick et al., J Am Acad Dermatol 1985; 13: 134).
In this report, the authors present the clinical, histological, immunohistochemical, and ultrastructural characteristics of secondary skin localizations of a neuroendocrine laryngeal tumor that occurred in a 61-year-old man. The complete follow up of the case is described and a brief revision of the terminology and classification of neuroendocrine neoplasms of the larynx is discussed, since a significant relationship exists between the degree of differentiation and biological behavior.
On histological examination, the secondary cutaneous localization appeared to be more dedifferentiated compared to the primary tumor. The immunohistochemical patterns of reactivity were similar in both neoplasms, showing expression of neuroendocrine and epithelial markers.
An important issue of prognostic significance is to differentiate a cutaneous metastasis of a neuroendocrine carcinoma from the primary small cell-undifferentiated carcinoma of the skin (Merkel cell carcinoma).
内脏起源的神经内分泌癌发生皮肤转移在索引文献中鲜有描述。其原发部位包括：肺（Wick等人，《美国皮肤病学会杂志》1985年；13: 134）、喉（Zambruno等人，《皮肤病与性病学年鉴》1989年；116: 855；Schmidt等人，《耳鼻喉科杂志》1994年；108: 272；Guerzider等人，《病理学杂志》1991年；11(4): 253）、纵隔（Yoshimasu等人，《皮肤病学杂志》2001年；28(3): 168）、子宫（Fogaca等人，《皮肤病理学杂志》1993年；20: 455）和胸腺（Wick等人，《美国皮肤病学会杂志》1985年；13: 134）。
在本报告中，作者呈现了一名61岁男性发生的神经内分泌喉肿瘤继发性皮肤定位的临床、组织学、免疫组化和超微结构特征。描述了该病例的完整随访情况，并讨论了喉神经内分泌肿瘤的术语和分类的简要修订，因为分化程度与生物学行为之间存在显著关系。
组织学检查显示，继发性皮肤定位与原发性肿瘤相比去分化程度更高。两种肿瘤的免疫组化反应模式相似，均显示神经内分泌和上皮标志物的表达。
一个具有预后意义的重要问题是区分神经内分泌癌的皮肤转移与原发性皮肤小细胞未分化癌（默克尔细胞癌）。
