Patel Raj, Adsay Volkan, Andea Aleodor
Department of Pathology and Dermatology, University of Alabama at Birmingham, Birmingham, AL;
Rare Tumors. 2010 Mar 31;2(1):e8. doi: 10.4081/rt.2010.e8.
Merkel cell carcinoma (MCC) or primary cutaneous neuroendocrine carcinoma is a malignant tumor considered to demonstrate differentiation towards Merkel cells that are present at the base of the epidermis or around the apical end of some hair follicles and are thought to play a yet uncertain role in sensory transduction. Here we present the case of a 54- year old female with a basal cell carcinoma (BCC) of the skin with neuroendocrine features (positivity for chromogranin) that has evolved during multiple recurrences and radiotherapy into a high-grade neuroendocrine carcinoma with morphological and immunohistochemical features of MCC (trabecular and nesting arrangement, positivity for chromogranin, cytokeratin 20, neuron specific enolase, and also neurosecretory granules on electron microscopy). The progression from a chromogranin positive basal cell carcinoma of the skin, to a high-grade neuroendocrine carcinoma demonstrates the potential for cross differentiation among skin tumors.
默克尔细胞癌（MCC）或原发性皮肤神经内分泌癌是一种恶性肿瘤，被认为是向默克尔细胞分化的肿瘤，默克尔细胞存在于表皮基部或一些毛囊顶端周围，在感觉传导中发挥的作用尚不确定。在此，我们报告一例54岁女性患者，其皮肤基底细胞癌（BCC）具有神经内分泌特征（嗜铬粒蛋白阳性），在多次复发和放疗过程中演变为高级别神经内分泌癌，具有MCC的形态学和免疫组化特征（小梁状和巢状排列、嗜铬粒蛋白、细胞角蛋白20、神经元特异性烯醇化酶阳性，电镜下可见神经分泌颗粒）。从嗜铬粒蛋白阳性的皮肤基底细胞癌进展为高级别神经内分泌癌，表明皮肤肿瘤之间存在交叉分化的可能性。
