右大腿部に生じた巨大メルケル細胞癌の１例

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  • A case of an enormous Merkel cell carcinoma in the lateral right thigh

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The patient was a 77-year-old male with an asymptomatic subcutaneous nodule on the lateral right thigh. Starting in June 2002, the nodule began to grow larger. After performing a skin biopsy, a local doctor suspected it to be Merkel cell carcinoma and referred the patient to our hospital. Upon examination, the nodule was found to be a dark-red colored, dome-shaped tumor 10.5×8.0cm in size. A histopathological examination showed the tumor to consist of a solid nest of cells formed of small, atypical cells with scanty cytoplasm and circular nuclei. Moreover, immunostaining showed the tumor to be positive for cytokeratin 20 and NSE. The tumor was diagnosed as Merkel cell carcinoma. We excised the tumor together with fascia within a radius of 3cm from the tumor margin, and then covered the excised area with a mesh skin graft. During the operation, metastases were found in the sentinel and 3 other lymph nodes among the 13 lymph nodes, and these 3 were then resected. [Skin Cancer (Japan) 2004; 19: 208-211]

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