Turk Tamara, Orlic Zeljka Crncevic, Smoljan Ivana, Nacinovic Antica, Bekafigo Irena Seili, Radic Jelena, Zamolo Gordana
J Med Case Rep. 2009 May 27;3:7270. doi: 10.1186/1752-1947-3-7270.
Merkel cell carcinoma is a rare and aggressive primary cutaneous neuroendocrine malignant tumor. The tumor has a high rate of local recurrence after surgical removal. Spontaneous regression appears to be relatively common in this rare type of tumor.
We describe the clinical course, cytological and histological findings of a Merkel cell carcinoma in a 70-year-old Caucasian woman, simultaneously diagnosed with chronic lymphatic leukemia. The tumor showed clinical regression after fine needle aspiration. At primary presentation, the tumor had no apparent leukocyte infiltration, but was completely cleared by T-cell mediated immunity within 3 weeks after fine needle aspiration.
Fine needle aspiration may have acted as a mechanical trigger involved in the activation of cell-mediated immunity, leading to the clinical and histological regression of the tumor. To the best of our knowledge, this is the first case report of spontaneous regression of Merkel cell carcinoma in a patient with a co-malignancy, that is to say, chronic lymphocytic leukemia.
默克尔细胞癌是一种罕见且侵袭性强的原发性皮肤神经内分泌恶性肿瘤。手术切除后,该肿瘤局部复发率很高。在这种罕见类型的肿瘤中,自发消退似乎相对常见。
我们描述了一名70岁白种女性默克尔细胞癌的临床病程、细胞学和组织学表现,该患者同时被诊断为慢性淋巴细胞白血病。细针穿刺后肿瘤出现临床消退。初次就诊时,肿瘤无明显白细胞浸润,但在细针穿刺后3周内被T细胞介导的免疫完全清除。
细针穿刺可能起到了机械触发作用,参与激活细胞介导的免疫,导致肿瘤的临床和组织学消退。据我们所知,这是首例合并恶性肿瘤(即慢性淋巴细胞白血病)的患者默克尔细胞癌自发消退的病例报告。