Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Extensive central nervous system involvement in Merkel cell carcinoma: a case report and review of the literature | Abul-Kasim et al. Journal of Medical Case Reports 2011 5 35 http content 5 1 35 JOURNALOF medical case reports CASE REPORT Open Access Extensive central nervous system involvement in Merkel cell carcinoma a case report and review of the literature Kasim Abul-Kasim1 Kristina Soderstrom1 Lennart Hallsten2 Abstract Introduction Merkel cell carcinoma is a rare malignant cutaneous neoplasm that is locally invasive and frequently metastasizes to lymph nodes liver lungs bone and brain. The incidence of Merkel cell carcinoma has increased in the past three decades. Case presentation A 65-year-old Caucasian man presented with a sudden onset of severe headache and a three-month history of balance disturbance. Magnetic resonance imaging revealed a large meningeal metastasis. The radiologic workup showed retroperitoneal and inguinal lymph node metastases. Biopsy of the inguinal lymph nodes showed metastases of Merkel cell carcinoma. Biopsy from three different suspected skin lesions revealed no Merkel cell carcinoma and the primary site of Merkel cell carcinoma remained unknown. Leptomeningeal metastases new axillary lymph node metastases and intraspinal epidural and intradural metastases were detected within six seven and eight months respectively from the start of symptoms despite treating the intracranial metastasis with gamma knife and the abdominal metastases with surgical dissection and external radiotherapy. This indicates the aggressive nature of the disease. Conclusion To the best of our knowledge this is the first report in the literature of an intracranial meningeal metastasis of Merkel cell carcinoma treated with gamma knife and of intraspinal intradural metastases of Merkel cell carcinoma. Despite good initial response to radiotherapy recurrence and occurrence of new metastases are common in Merkel cell carcinoma. Introduction Merkel cell carcinoma MCC is a rare malignant neoplasm of the skin that is locally invasive and frequently .
