Mweempwa Angela, Tan Alvin, Dray Michael
Medical Oncology, Waikato Hospital, Selwyn Street and Pembroke Street, Hamilton, 3204, New Zealand.
Histology Department, Waikato Hospital, Selwyn Street and Pembroke Street, Hamilton, 3204, New Zealand.
J Med Case Rep. 2016 Nov 5;10(1):314. doi: 10.1186/s13256-016-1102-5.
Merkel cell carcinoma is a rare and aggressive neuroendocrine tumor that commonly arises in the skin. It is rare for it to occur in the testes. There are only seven cases of testicular Merkel cell carcinoma reported in the literature.
A 66-year-old Maori man presented to our hospital with left testicular swelling. His alpha-fetoprotein and beta-human chorionic gonadotrophin levels were within normal limits. His lactate dehydrogenase concentration was elevated to 267 U/L. Ultrasound imaging confirmed a large testicular mass, and he underwent left orchiectomy. His histological examination revealed a neuroendocrine tumor with an immunostaining pattern suggesting Merkel cell carcinoma. He presented to our hospital again 3 months later with right testicular swelling that was confirmed on ultrasound sonography to be a tumor. He underwent a right orchiectomy, and his histological examination revealed metastatic Merkel cell carcinoma. A primary lesion was not identified, and computed tomographic imaging did not reveal spread to other organs. He received six cycles of adjuvant carboplatin and etoposide chemotherapy and remained disease-free 18 months after completion of chemotherapy.
Given the paucity of studies, standard adjuvant treatment for testicular Merkel cell carcinoma remains uncertain, although platinum-based chemotherapy seems to be an appropriate option.
默克尔细胞癌是一种罕见的侵袭性神经内分泌肿瘤，通常发生于皮肤。发生于睾丸者罕见。文献中仅报道了7例睾丸默克尔细胞癌。
一名66岁的毛利男性因左侧睾丸肿大就诊于我院。其甲胎蛋白和β-人绒毛膜促性腺激素水平在正常范围内。乳酸脱氢酶浓度升高至267 U/L。超声成像证实睾丸有一巨大肿块，遂行左侧睾丸切除术。组织学检查显示为神经内分泌肿瘤，免疫染色模式提示为默克尔细胞癌。3个月后，他再次因右侧睾丸肿大就诊于我院，超声检查证实为肿瘤。他接受了右侧睾丸切除术，组织学检查显示为转移性默克尔细胞癌。未发现原发灶，计算机断层扫描成像未显示扩散至其他器官。他接受了6个周期的辅助卡铂和依托泊苷化疗，化疗结束后18个月无疾病复发。
鉴于研究较少，睾丸默克尔细胞癌的标准辅助治疗仍不明确，尽管铂类化疗似乎是一个合适的选择。
