Tang C K, Toker C, Nedwich A, Zaman A N
Am J Dermatopathol. 1982 Dec;4(6):537-48. doi: 10.1097/00000372-198212000-00011.
Three unusual primary neoplasms in the skin that occurred in elderly patients (64, 77, and 69 years of age) are presented. Two histologic components were found in each of the three neoplasms, one being small cell or oat cell-like carcinoma and the other squamous cell carcinoma. Study by electron microscopy revealed neurosecretory granules, though few, in the small cell component. The lack of clinical evidence of oat cell carcinoma elsewhere, the autopsy finding of two histologic components in one patient, and the findings by conventional and electron microscopy lead us to conclude that these three neoplasms are primary in the skin and of Merkel cell origin. We suggest further that small cell carcinoma of the skin represents a poorly differentiated counterpart of trabecular carcinoma. The spectrum of malignant Merkel cell neoplasm is, therefore, expanding. Two of our three patients died of their neoplasms 2 and 2 1/2 years, respectively, after the initial diagnosis.
本文报告了3例发生于老年患者（年龄分别为64、77和69岁）的皮肤原发性罕见肿瘤。这3例肿瘤均发现有两种组织学成分，一种为小细胞或燕麦样癌，另一种为鳞状细胞癌。电镜研究显示，小细胞成分中存在神经分泌颗粒，数量虽少。其他部位缺乏燕麦细胞癌的临床证据、1例患者尸检发现两种组织学成分以及常规和电镜检查结果，使我们得出结论，这3例肿瘤是皮肤原发性的，起源于默克尔细胞。我们进一步认为，皮肤小细胞癌是小梁癌的低分化对应物。因此，恶性默克尔细胞瘤的范围正在扩大。3例患者中有2例在初次诊断后分别于2年和2年半死于肿瘤。
