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13 年生存的寡转移 Merkel 细胞癌:一例报告。

13-year survival oligometastatic Merkel cell carcinoma: a case report.

机构信息

Radiation Department, Institut de Cancérologie de Lorraine-Alexis-Vautrin, Vandoeuvre-Lès-Nancy Cedex, France.

Université de Lorraine, Faculté de Médecine de Nancy, 9 avenue de la Forêt de Haye, 54505, Vandoeuvre-Lès-Nancy, France.

出版信息

J Med Case Rep. 2024 Sep 18;18(1):455. doi: 10.1186/s13256-024-04750-6.

Abstract

BACKGROUND

Merkel cell carcinomas are rare, aggressive skin tumors with high metastatic potential and poor prognosis. Their treatment is classically based on surgery with adjuvant external radiotherapy for localized tumors or on immunotherapy or chemotherapy, sometimes associated with radiotherapy, for metastatic stages. Those tumors are highly radiosensitive due to their neuroendocrine and undifferentiated nature, but they usually fail to rapidly respond to treatment.

CASE PRESENTATION

We report the case of a 65-year-old retired female patient of Caucasian (German) origin with locally advanced Merkel cell carcinoma of the buttock, with pancreatic metastases synchronous at diagnosis, treated with local radiotherapy of the right buttock without regional lymph node irradiation followed by a sequential chemotherapy; 1 year later, the patient developed an isolated pancreatic recurrence treated with exclusive radiotherapy. The patient was still alive at 13 years with complete remission.

CONCLUSION

External radiotherapy can be an effective alternative to surgery for locally advanced or even oligometastatic Merkel cell carcinomas.

摘要

背景

默克尔细胞癌是一种罕见的侵袭性皮肤肿瘤,具有较高的转移潜能和不良预后。其治疗经典方法是手术联合局部肿瘤辅助外放疗,或转移性阶段的免疫治疗或化疗,有时联合放疗。由于其神经内分泌和未分化的性质,这些肿瘤对放疗高度敏感,但通常不能迅速对治疗产生反应。

病例介绍

我们报告了一例 65 岁的白人(德国裔)女性患者,患有臀部局部晚期默克尔细胞癌,诊断时伴有胰腺转移,局部右臀部放疗而未进行区域淋巴结照射,随后序贯化疗;1 年后,患者出现孤立性胰腺复发,仅接受放疗。13 年后,患者仍存活且完全缓解。

结论

对于局部晚期甚至寡转移的默克尔细胞癌,外放疗可以替代手术作为一种有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d63/11409691/a58853d6c57c/13256_2024_4750_Fig1_HTML.jpg

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