Imaging of Merkel cell carcinoma of the eyelid: A case report

Zhu,Guangwen; Xie,Liting; Hu,Xianwen

doi:10.3892/ol.2024.14252

Imaging of Merkel cell carcinoma of the eyelid: A case report

Authors:
- Guangwen Zhu
- Liting Xie
- Xianwen Hu
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Affiliations: Department of Endocrinology, Zunyi Hospital of Traditional Chinese Medicine, Zunyi, Guizhou 563003, P.R. China, Department of Gynecology, Zunyi Hospital of Traditional Chinese Medicine, Zunyi, Guizhou 563000, P.R. China, Department of Nuclear Medicine, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
Published online on: January 23, 2024 https://doi.org/10.3892/ol.2024.14252
Article Number: 119
Copyright: © Zhu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Merkel cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma commonly found in older adults in areas of the skin that are susceptible to ultraviolet ray damage. The current study reports the case of a 79‑year‑old woman who presented to the Affiliated Hospital of Zunyi Medical University (Zunyi, China) with a painless lump in the lower eyelid of the left eye accompanied by photophobic tears for 4 months. Head computed tomography (CT) and magnetic resonance imaging (MRI) showed a space‑occupying lesion ~2.8x2.4 cm in size outside the left orbital muscle cone, which was poorly demarcated from the surrounding normal tissues. Markedly intense and tortuous walking vascular shadows were observed within the tumor tissues. Fluorine‑18‑fluorodeoxyglucose positron emission tomography (^18F‑FDG PET)/CT revealed increased ^18F‑FDG uptake in the corresponding lesions. Based on these imaging features, a malignant tumor was suspected. The patient subsequently underwent surgery. Postoperative pathology and immunohistochemistry revealed MCC. The clinical presentation of MCC is usually a painless soft‑tissue nodule or mass that grows rapidly over a short period and is flesh‑colored, bluish red or purple. A slightly hyperdense mass on CT, with equal T1‑weighted and slightly longer T2‑weighted MRI signals, and mild enhancement on contrast‑enhanced scans, accompanied by significantly enhanced distorted vascular shadows and increased ^18F‑FDG uptake on PET/CT, are valuable in the diagnosis of eyelid MCC.

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1	Toker C: Trabecular carcinoma of the skin. Arch Dermatol. 105:107–110. 1972. View Article : Google Scholar : PubMed/NCBI
2	Paulson KG, Park SY, Vandeven NA, Lachance K, Thomas H, Chapuis AG, Harms KL, Thompson JA, Bhatia S, Stang A and Nghiem P: Merkel cell carcinoma: Current US incidence and projected increases based on changing demographics. J Am Acad Dermatol. 78:457–463.e2. 2018. View Article : Google Scholar : PubMed/NCBI
3	Zaar O, Gillstedt M, Lindelöf B, Wennberg-Larkö AM and Paoli J: Merkel cell carcinoma incidence is increasing in Sweden. J Eur Acad Dermatol Venereol. 30:1708–1713. 2016. View Article : Google Scholar : PubMed/NCBI
4	Fondain M, Dereure O, Uhry Z, Guizard AV, Woronoff AS, Colonna M, Molinie F, Bara S, Velten M, Marrer E, et al: Merkel cell carcinoma in France: A registries-based, comprehensive epidemiological survey. J Eur Acad Dermatol Venereol. 32:1292–1296. 2018. View Article : Google Scholar : PubMed/NCBI
5	Coggshall K, Tello TL, North JP and Yu SS: Merkel cell carcinoma: An update and review: Pathogenesis, diagnosis, and staging. J Am Acad Dermatol. 78:433–442. 2018. View Article : Google Scholar : PubMed/NCBI
6	Fazio N, Maisonneuve P, Spada F, Gervaso L, Cella CA, Pozzari M, Zerini D, Pisa E, Fumagalli C, Barberis M, et al: Nodal merkel cell carcinoma with unknown primary site and no distant metastasis: A single-center series. Cancers (Basel). 14:47772022. View Article : Google Scholar : PubMed/NCBI
7	Feng H, Shuda M, Chang Y and Moore PS: Clonal integration of a polyomavirus in human Merkel cell carcinoma. Science. 319:1096–1100. 2008. View Article : Google Scholar : PubMed/NCBI
8	Moll I, Zieger W and Schmelz M: Proliferative Merkel cells were not detected in human skin. Arch Dermatol Res. 288:184–187. 1996. View Article : Google Scholar : PubMed/NCBI
9	Zur Hausen A, Rennspiess D, Winnepenninckx V, Speel EJ and Kurz AK: Early B-cell differentiation in Merkel cell carcinomas: Clues to cellular ancestry. Cancer Res. 73:4982–4987. 2013. View Article : Google Scholar : PubMed/NCBI
10	Zaggana E, Konstantinou MP, Krasagakis GH, de Bree E, Kalpakis K, Mavroudis D and Krasagakis K: Merkel cell carcinoma-update on diagnosis, management and future perspectives. Cancers (Basel). 15:1032022. View Article : Google Scholar : PubMed/NCBI
11	Tello TL, Coggshall K, Yom SS and Yu SS: Merkel cell carcinoma: An update and review: Current and future therapy. J Am Acad Dermatol. 78:445–454. 2018. View Article : Google Scholar : PubMed/NCBI
12	Chen L, Zhu L, Wu J, Lin T, Sun B and He Y: Giant Merkel cell carcinoma of the eyelid: A case report and review of the literature. World J Surg Oncol. 9:582011. View Article : Google Scholar : PubMed/NCBI
13	Watanabe N, Shimizu M, Kageyama M, Kitagawa K, Hayasaka S and Seto H: 123I-MIBG SPECT of Merkel cell carcinoma. Br J Radiol. 71:886–887. 1998. View Article : Google Scholar : PubMed/NCBI
14	Feng Y, Song X and Jia R: Case Report: Favorable response to the tyrosine kinase inhibitor apatinib in recurrent merkel cell carcinoma. Front Oncol. 11:6253602021. View Article : Google Scholar : PubMed/NCBI
15	Dunlop P, Sapp H, Logan PM and Walsh NM: Merkel cell carcinoma of the abdominal wall. Skeletal Radiol. 27:396–399. 1998. View Article : Google Scholar : PubMed/NCBI
16	Moayed S, Maldjianb C, Adam R and Bonakdarpour A: Magnetic resonance imaging appearance of metastatic Merkel cell carcinoma to the sacrum and epidural space. Magn Reson Imaging. 18:1039–1042. 2000. View Article : Google Scholar : PubMed/NCBI
17	Hawryluk EB, O'Regan KN, Sheehy N, Guo Y, Dorosario A, Sakellis CG, Jacene HA and Wang LC: Positron emission tomography/computed tomography imaging in Merkel cell carcinoma: A study of 270 scans in 97 patients at the Dana-Farber/Brigham and Women's Cancer Center. J Am Acad Dermatol. 68:592–599. 2013. View Article : Google Scholar : PubMed/NCBI
18	Concannon R, Larcos GS and Veness M: The impact of (18)F-FDG PET-CT scanning for staging and management of Merkel cell carcinoma: Results from Westmead Hospital, Sydney, Australia. J Am Acad Dermatol. 62:76–84. 2010. View Article : Google Scholar : PubMed/NCBI
19	Akaike G, Akaike T, Fadl SA, Lachance K, Nghiem P and Behnia F: Imaging of merkel cell carcinoma: What imaging experts should know. Radiographics. 39:2069–2084. 2019. View Article : Google Scholar : PubMed/NCBI
20	Peloschek P, Novotny C, Mueller-Mang C, Weber M, Sailer J, Dawid M, Czerny C, Dudczak R, Kletter K and Becherer A: Diagnostic imaging in Merkel cell carcinoma: Lessons to learn from 16 cases with correlation of sonography, CT, MRI and PET. Eur J Radiol. 73:317–323. 2010. View Article : Google Scholar : PubMed/NCBI
21	Kim HJ, Lee KC, Kang CH, Ahn KS and Kim CH: Characteristic imaging features of merkel cell carcinoma: A case report. Curr Med Imaging. 17:562–566. 2021. View Article : Google Scholar : PubMed/NCBI
22	Enzenhofer E, Ubl P, Czerny C and Erovic BM: Imaging in patients with merkel cell carcinoma. J Skin Cancer. 2013:9731232013. View Article : Google Scholar : PubMed/NCBI
23	Shoji MK, Tran AQ, Lazzarini TA, Choi CJ and Tse BC: Basal cell carcinoma and eccrine porocarcinoma of the eyelid. Ophthalmic Plast Reconstr Surg. 37:e53–e56. 2021. View Article : Google Scholar : PubMed/NCBI
24	Tang M, Huang R, Chen J, Sheng M, Zhang Z, Xing J, Guo L and Li Y: Clinical value of high-resolution dynamic contrast-enhanced (DCE) MRI in diagnosis of cutaneous squamous cell carcinoma. Skin Res Technol. 27:511–520. 2021. View Article : Google Scholar : PubMed/NCBI
25	Soror NN, Lutaya I, Shah P, Hemrock L, Bennett R and Gibson G: A rare case of primary adenocarcinoma of the eyelid: Case presentation and review of literature. Cureus. 13:e165802021.PubMed/NCBI
26	Barat M, Guegan-Bart S, Cottereau AS, Guillo E, Hoeffel C, Barret M, Gaujoux S, Dohan A and Soyer P: CT, MRI and PET/CT features of abdominal manifestations of cutaneous melanoma: A review of current concepts in the era of tumor-specific therapies. Abdom Radiol (NY). 46:2219–2235. 2021. View Article : Google Scholar : PubMed/NCBI
27	Evans J, Vo KBH and Schmitt M: Chalazion: Racial risk factors for formation, recurrence, and surgical intervention. Can J Ophthalmol. 57:242–246. 2022. View Article : Google Scholar : PubMed/NCBI
28	Schrama D, Sarosi EM, Adam C, Ritter C, Kaemmerer U, Klopocki E, König EM, Utikal J, Becker JC and Houben R: Characterization of six Merkel cell polyomavirus-positive Merkel cell carcinoma cell lines: Integration pattern suggest that large T antigen truncating events occur before or during integration. Int J Cancer. 145:1020–1032. 2019. View Article : Google Scholar : PubMed/NCBI
29	Kervarrec T, Tallet A, Miquelestorena-Standley E, Houben R, Schrama D, Gambichler T, Berthon P, Le Corre Y, Hainaut-Wierzbicka E, Aubin F, et al: Diagnostic accuracy of a panel of immunohistochemical and molecular markers to distinguish Merkel cell carcinoma from other neuroendocrine carcinomas. Mod Pathol. 32:499–510. 2019. View Article : Google Scholar : PubMed/NCBI
30	Bichakjian CK, Olencki T, Aasi SZ, Alam M, Andersen JS, Blitzblau R, Bowen GM, Contreras CM, Daniels GA, Decker R, et al: Merkel Cell Carcinoma, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 16:742–774. 2018. View Article : Google Scholar : PubMed/NCBI
31	Dasanu CA, Del Rosario M, Codreanu I, Hyams DM and Plaxe SC: Inferior outcomes in immunocompromised Merkel cell carcinoma patients: Can they be overcome by the use of PD1/PDL1 inhibitors. J Oncol Pharm Pract. 25:214–216. 2019. View Article : Google Scholar : PubMed/NCBI
32	Frohm ML, Griffith KA, Harms KL, Hayman JA, Fullen DR, Nelson CC, Wong SL, Schwartz JL and Bichakjian CK: Recurrence and survival in patients with merkel cell carcinoma undergoing surgery without adjuvant radiation therapy to the primary site. JAMA Dermatol. 152:1001–1007. 2016. View Article : Google Scholar : PubMed/NCBI
33	Kaufman HL, Russell J, Hamid O, Bhatia S, Terheyden P, D'Angelo SP, Shih KC, Lebbé C, Linette GP, Milella M, et al: Avelumab in patients with chemotherapy-refractory metastatic Merkel cell carcinoma: A multicentre, single-group, open-label, phase 2 trial. Lancet Oncol. 17:1374–1385. 2016. View Article : Google Scholar : PubMed/NCBI
34	Lemos BD, Storer BE, Iyer JG, Phillips JL, Bichakjian CK, Fang LC, Johnson TM, Liegeois-Kwon NJ, Otley CC, Paulson KG, et al: Pathologic nodal evaluation improves prognostic accuracy in Merkel cell carcinoma: Analysis of 5823 cases as the basis of the first consensus staging system. J Am Acad Dermatol. 63:751–761. 2010. View Article : Google Scholar : PubMed/NCBI