A rare case of metastatic Merkel cell carcinoma presenting without a primary cutaneous lesion: A case report.
Na Luo, Wen Xiao, Lijun Su et al.
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Case in brief
A 44-year-old male presented with a painless, enlarging mass in the right groin, with no prior skin lesions. Pathological examination confirmed metastatic Merkel cell carcinoma (MCC) through immunohistochemical profiling. Imaging revealed widespread metastases to the pancreas, abdomen, and mediastinum without a primary cutaneous lesion. Despite surgical excision and subsequent chemo-immunotherapy, the disease progressed rapidly, leading to the patient's death approximately 14 months after presentation.
Diagnostic / clinical pearl
Merkel cell carcinoma can present as metastatic disease without an identifiable primary cutaneous lesion, necessitating its consideration in the differential diagnosis of metastatic neuroendocrine tumors.
Why it matters
This case highlights the importance of comprehensive immunohistochemistry in diagnosing MCC and the aggressive nature of the disease, which may not respond well to standard therapies.