Jockisch Kalah, Abdeen Yazan, Alderink Carlisle, Flippin Tony, Kuru Sugabramya, Shaaban Hamid
Department of Internal Medicine, Lincoln Memorial University-DeBusk College of Osteopathic Medicine, Harrogate, Tennessee, USA.
Department of Pulmonary, Mercy Hospital, Fort Smith, AR, USA.
Asian J Neurosurg. 2020 Feb 25;15(1):128-131. doi: 10.4103/ajns.AJNS_5_18. eCollection 2020 Jan-Mar.
Merkel cell carcinoma is a cutaneous neuroendocrine malignancy that has an aggressive nature. Classically, it affects the elderly Caucasian population with a predilection for the sun-exposed areas of the body. Pathogenesis has been linked to ultraviolet radiation, immunosuppression, and the Merkel cell polyomavirus. Definitive diagnosis entails histologic evaluation and immunohistochemical staining. With its generalized appearance and tendency for metastasis, a high index of suspicion must be utilized. In this case, we present the unique presentation of Merkel cell carcinoma as a rapidly enlarging lymph node with metastatic disease to the spinal column presenting as new-onset low back and radicular pain.
默克尔细胞癌是一种具有侵袭性的皮肤神经内分泌恶性肿瘤。传统上，它影响老年白种人，好发于身体暴露于阳光的部位。发病机制与紫外线辐射、免疫抑制和默克尔细胞多瘤病毒有关。明确诊断需要组织学评估和免疫组化染色。由于其临床表现广泛且有转移倾向，必须保持高度怀疑指数。在此病例中，我们展示了默克尔细胞癌的独特表现，即一个迅速增大的淋巴结伴有脊柱转移，表现为新发的下背部疼痛和神经根性疼痛。
