Metastatic Merkel Cell Carcinoma to the Eye

doi:10.1016/S0161-6420(91)32116-X

Ophthalmology

Volume 98, Issue 9, September 1991, Pages 1432-1434

https://doi.org/10.1016/S0161-6420(91)32116-X Get rights and content

Abstract

Merkel cell carcinoma is an infrequent but highly aggressive cutaneous neoplasm. Previous reports of ocular involvement have included primary eyelid carcinomas, eyelid and orbital metastases, and a clinically diagnosed choroidal metastasis. The authors report the histopathologic documentation of a metastatic lesion to the ciliary body, confirming the intraocular metastatic potential of this tumor.

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Cited by (17)

Merkel cell carcinoma of the eyelid. A series of 5 cases and review of the literature
2016, Archivos de la Sociedad Espanola de Oftalmologia
Estudio descriptivo de 5 casos clínicos de carcinoma de Merkel a nivel palpebral, destacando las características clínicas, histopatológicas, el manejo y seguimiento. Revisión de literatura asociada.
Revisión retrospectiva de fichas clínicas y entrevista telefónica a 5 pacientes tratados por carcinoma de células de Merkel entre los años 2006-2013, en el Departamento de Órbita y Oculoplástica del Hospital Clínico de la Universidad de Chile.
Cinco pacientes (2 hombres, 3 mujeres), de 79,2 años (rango 64-94 años), con una evolución de 10 semanas (rango 5-16 semanas), con un tamaño tumoral de 2,5 × 2 x 2,1 cm en promedio al momento de la cirugía. Descritos como una masa nodular, exofítica, sólida, de color rojizo. Sin adenopatías sospechosas ni metástasis en el primer enfrentamiento. Tipificados como T2N0M0, tras la primera cirugía con criterios oncológicos. Se observó, durante el seguimiento, 2 recurrencias en nódulo linfoide. Encontramos metástasis a distancia en un paciente. El diagnóstico histopatológico se confirmó mediante biopsia corriente más inmunohistoquímica. La estrategia quirúrgica fue con extirpación completa, control de márgenes libres y reconstrucción palpebral con colgajo de Hughes, Cutler-Beard o cierre primario.
El diagnóstico precoz, la extirpación amplia del tumor con control de márgenes libres intraoperatorio con cirugía convencional o técnica de Mohs y una adecuada reconstrucción palpebral permiten una supervivencia en pacientes añosos portadores de este tumor a nivel palpebral. Se recomienda el estudio de ganglio centinela y biopsia en la intervención primaria, junto a una radioterapia posterior, que disminuye la recurrencia y aumentaría la supervivencia.
Presentation of 5 clinical cases of Merkel cell carcinoma of the eyelid, highlighting the clinical, histopathological, management, and monitoring features. Review of related literature.
Retrospective review of clinical records and telephone interview of the 5 patients treated for Merkel cell carcinoma between 2006 and 2013, in the Orbit and Oculoplastic Department, Clinical Hospital of the University of Chile.
Five patients (2 men, 3 women); 79.2 years (range 64-94 years), with a mean onset of 10 weeks (range 5-16 weeks), tumour size reaching a mean of 2.5 × 2 × 2.1 cm at the time of surgery. Described as a nodular mass, exophytic, solid, reddish coloured. With no infiltrated lymph nodes or metastases in the first match. Staging as T2N0M0, after the first surgery with oncological criteria. Two lymph node recurrences detected during monitoring. Distant metastasis was found in one patient. The histopathological diagnosis was confirmed by immunohistochemical study of the biopsy. The surgical strategy was full excision, control of surgical margins in the intraoperative period, and eyelid reconstruction with Hughes flap, Cutler/Beard flap or primary closure, depending on the case.
Early diagnosis, wide excision of the tumour with intraoperative control of clear margins with conventional or Mohs surgery, and proper eyelid reconstruction are adequate for a good survival in elderly patients with this eyelid tumour. The study of sentinel lymph node biopsy in primary intervention is recommended; with subsequent radiotherapy to decrease the recurrence and increase survival.
Merkel Cell Carcinoma of the Eyelid. Review of the Literature and Report of Patients with Merkel Cell Carcinoma Showing Spontaneous Regression
2008, Ophthalmology
To evaluate the clinical and histopathologic characteristics of Merkel cell carcinoma (MCC) of the eyelid.
Retrospective case series and literature review.
Three consecutive patients with MCC of the eyelid who were referred to the Ocular Oncology Unit of Leiden University Medical Center, Netherlands.
Clinical records and histopathologic material of patients with eyelid MCC were reviewed. The clinical presentation and treatment were evaluated.
Clinical and histopathologic description of eyelid MCC, with histologic proof of spontaneous regression of the tumor.
Three patients with MCC of the eyelid were included. Diagnosis was made by pathologic investigation and immunohistochemistry (S100, cytokeratin 20, epithelial membrane antigen, chromogranin). Two of the patients showed histologically proven complete spontaneous regression after nonradical excision of the tumor. After local excision, none of the MCCs demonstrated local recurrence, without regional or distant metastases. Mean clinical follow-up was 50 months.
Nonocular MCC is known to recur in 66% of patients and to be lethal in almost 33%. Merkel cell carcinoma of the eyelid is a rare malignancy that can not be recognized clinically. Clinical differential diagnosis must be made with a chalazion, and histopathologic differential diagnosis must be made with small cell carcinomas. Close follow-up of these patients is advised because of the potential high recurrence rate and lymphatic spread. The immunologic phenomenon of spontaneous regression points out the importance of the immune system in this disease.
Merkel cell carcinoma
1993, Journal of the American Academy of Dermatology
Merkel cell carcinoma is a malignant neuroendocrine tumor with features of epithelial differentiation. Biologically aggressive, it may be difficult to diagnose and, particularly in its late stages, even more difficult to treat effectively. This article addresses what is known and what is still controversial about the histogenesis, diagnosis, and management of Merkel cell carcinoma and the structure and function of the Merkel cell from which it is believed to be derived. The incidence, clinical presentation and diagnosis, ultrastructure, immunocytochem-istry, treatment, and prognosis of this tumor will be discussed.
Retinal imaging with en face and cross-sectional optical coherence tomography delineates outer retinal changes in cancer-associated retinopathy secondary to Merkel cell carcinoma
2015, Journal of Ophthalmic Inflammation and Infection
Primary merkel cell carcinoma of the eyelid – Clinical, histopathological, immunohistochemical and electron microscopical features: A case report
2015, Srpski Arhiv za Celokupno Lekarstvo
Orbital metastasis secondary to merkel cell carcinoma: Case report and literature review
2013, Orbit

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Metastatic Merkel Cell Carcinoma to the Eye

Abstract

Clin Neurol Neurosurg

Surv Ophthalmol

Trabecular carcinoma of the skin

Arch Dermatol

Merkel cell neoplasms: histology, electron microscopy, biology, and histogenesis

Am J Dermatopathol

Unusual cutaneous carcinoma with features of small cell (oat cell-like) and squamous cell carcinomas. A variant of malignant Merkel cell neoplasm

Am J Dermatopathol

Merkel cell tumor of the eyelids. A clinicopathologic case report

Arch Ophthalmol

Merkel cell carcinoma: malignant neuroendocrine tumour of the eyelid

Br J Ophthalmol

Malignant Merkel cell neoplasm of the eyelid

Arch Ophthalmol