Coşkuncan N, Kazokoglu H, Sav A, Bavbek T, Ogut M S, Temel A
Department of Ophthalmology, Marmara University Hospital, Istanbul, Turkey.
Eur J Surg Oncol. 1994 Oct;20(5):587-92.
A case of Merkel cell tumour that developed on the left upper lid of a 76-year-old white man is reported. The diagnosis was ultrastructurally made by demonstrating characteristic light microscopic features of Merkel cell carcinoma; such as large, round nuclei and frequent mitoses. Immunohistochemically, the tumour cells were shown to possess simple epithelia-type keratin intermediate filaments. Merkel cell tumour probably develops from precursor cells which give rise to keratinocytes and Merkel cells, and nearly one out of 10 Merkel cell tumours occur in the eyelid and periocular region. They tend to be bulging lesions near the lid margin of elderly patients. The condition can be misdiagnosed as lymphoma, oat cell carcinoma, malignant melanoma, sweat gland tumours, neuroblastoma and Ewing's sarcoma, and frequently invades lymphatic vessels. Nearly one out of three Merkel cell tumours recur and two thirds cause regional lymph node metastases. Wide surgical resection and reconstructive procedures, should be followed by routine postoperative irradiation. This patient was treated with wide resection and the Cutler-Beard technique, then scheduled for radiotherapy.
报告了一例发生在一名76岁白人男性左上眼睑的默克尔细胞肿瘤。通过超微结构观察到默克尔细胞癌的特征性光镜表现，如大的圆形核和频繁的有丝分裂，从而做出诊断。免疫组织化学显示肿瘤细胞具有简单上皮型角蛋白中间丝。默克尔细胞肿瘤可能起源于产生角质形成细胞和默克尔细胞的前体细胞，每10例默克尔细胞肿瘤中约有1例发生在眼睑和眼周区域。它们往往是老年患者眼睑边缘附近的隆起病变。该疾病可能被误诊为淋巴瘤、燕麦细胞癌、恶性黑色素瘤、汗腺肿瘤、神经母细胞瘤和尤因肉瘤，并且经常侵犯淋巴管。近三分之一的默克尔细胞肿瘤会复发，三分之二会导致区域淋巴结转移。广泛的手术切除和重建手术之后，应常规进行术后放疗。该患者接受了广泛切除和卡特勒-比尔德技术治疗，然后安排进行放疗。
