Bertrand M, Mirabel X, Desmedt E, Vercambre-Darras S, Martin de Lassalle E, Bouchindhomme B, Guerreschi P, Martinot V, Mortier L
Service de dermatologie, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France.
Ann Dermatol Venereol. 2013 Jan;140(1):41-5. doi: 10.1016/j.annder.2012.10.598. Epub 2012 Dec 20.
Merkel cell carcinoma (MCC), a rare and aggressive neuroendocrine tumour, appears primarily on sun-exposed areas in light-skinned elderly subjects. UV exposure and profound immunosuppression (particularly in a setting of solid organ transplantation, haematological malignancies, HIV) constitute the principal risk factors. The aetiopathogenesis of this cancer is not known, although a polyomavirus involved in the oncogenic process was recently discovered. The carcinogenic effect of ionizing radiation, while not clearly established, has been suspected in rare cases involving the onset of MCC in irradiated zones. We report a new case of case of MCC in a patient previously undergoing radiotherapy.
A 59-year-old-man underwent radiotherapy for a Darier-Ferrand dermatofibrosarcoma on the left shoulder and developed MCC at the same site 38 years later.
The time between radiotherapy and diagnosis of MCC, its site within the radiation field (radio-dermatitis), the description of similar cases in the literature concerning the onset of MCC in irradiated areas, and the known carcinogenic effects of ionizing radiation all militate strongly in favour of the radiation-induced nature of MCC.
默克尔细胞癌（MCC）是一种罕见且侵袭性强的神经内分泌肿瘤，主要出现在浅色皮肤的老年受试者的阳光暴露部位。紫外线暴露和严重免疫抑制（特别是在实体器官移植、血液系统恶性肿瘤、HIV感染的情况下）是主要危险因素。尽管最近发现一种多瘤病毒参与致癌过程，但这种癌症的病因发病机制尚不清楚。电离辐射的致癌作用虽未明确证实，但在罕见的辐射区域发生MCC的病例中受到怀疑。我们报告了1例先前接受过放疗的患者发生MCC的新病例。
一名59岁男性因左肩部达里埃 - 费朗皮肤纤维肉瘤接受放疗，38年后在同一部位发生了MCC。
放疗与MCC诊断之间的时间间隔、其在辐射野内的位置（放射性皮炎）、文献中关于辐射区域发生MCC的类似病例描述以及已知的电离辐射致癌作用，都有力地支持了MCC是由辐射诱发的性质。
