Watanabe Genki, Fukunaga Yosuke, Nagasaki Toshiya, Akiyoshi Takashi, Konishi Tsuyoshi, Fujimoto Yoshiya, Nagayama Satoshi, Ueno Masashi
Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Asian J Endosc Surg. 2017 Nov;10(4):427-429. doi: 10.1111/ases.12389. Epub 2017 Jul 6.
Merkel cell carcinoma (MCC) is a rare neuroendocrine carcinoma of the skin. It has a high propensity for recurrence and metastasis, and there is no clearly defined treatment. MCC recurrence at the pelvic lymph node has rarely been reported. Herein, we report a patient with pelvic lymph node recurrence of MCC that was dissected laparoscopically. Nine years before presenting to us, a 76-year-old male patient had been diagnosed with MCC, and since then, he had had two recurrences. The most recent recurrence-the third recurrence-involved a tumor that had been detected at the right pelvic lymph node, and MCC recurrence was suspected after several imaging studies. Laparoscopic right pelvic lymph node dissection was conducted, and pathological findings confirmed MCC recurrence. The patient was discharged on postoperative day 8 and had no recurrence for 2 years as detected by imaging. This case report demonstrates the benefits of laparoscopic treatment of MCC recurrence with respect to intraoperative magnified vision and a more comfortable postoperative course for the patient.
默克尔细胞癌(MCC)是一种罕见的皮肤神经内分泌癌。它具有较高的复发和转移倾向,且尚无明确的治疗方法。盆腔淋巴结的MCC复发鲜有报道。在此,我们报告一例通过腹腔镜手术切除盆腔淋巴结复发的MCC患者。在前来我院就诊的九年前,一名76岁男性患者被诊断为MCC,自那时起,他已经经历了两次复发。最近一次复发——第三次复发——累及右侧盆腔淋巴结处检测到的肿瘤,经过多项影像学检查后怀疑为MCC复发。实施了腹腔镜下右侧盆腔淋巴结清扫术,病理结果证实为MCC复发。患者术后第8天出院,影像学检查显示2年内无复发。本病例报告证明了腹腔镜治疗MCC复发在术中放大视野以及为患者带来更舒适术后过程方面的益处。