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Spontaneous Regression of Dermal Metastases in Merkel Cell Carcinoma

Anna Xinyin See, Melissa Ching Ching Teo


Introduction: Merkel cell carcinoma (MCC) or cutaneous neuroendocrine carcinoma is a rare and aggressive cutaneous malignancy. Interestingly, despite its aggressive nature, complete spontaneous regression of MCC has been reported, mostly of the head and neck sites, and after biopsy or fine-needle aspiration sampling. There has been speculation that the biopsy of MCC may trigger complete spontaneous tumor regression via stimulation of the immune system. Spontaneous regression of metastatic MCC lesions after the excision of the main lesion, however, has not been reported in English literature.

Presentation of case: We report an extremely rare case of MCC of the left gluteal region with left inguinal lymphadenopathy and metastatic dermal nodules who underwent excision of the main lesion and was noted to have spontaneous regression of his dermal metastases post-operatively.

Conclusions: Spontaneous regression of MCC remains a poorly understood phenomenon. Further research into the histopathological features and immunity status should be considered to elucidate the mechanism underlying this phenomenon, as it will potentially be life-saving for patients with this rare malignancy, whose median survival will otherwise be measured in months.


Merkel cell carcinoma; spontaneous regression; metastasis

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Toker C. Trabecular carcinoma of the skin. Archives of Dermatology. 1972, 105:107-110

Santamaria-Barria JA, Boland GM, Yeap BY, et al. Merkel cell carcinoma: 30-year experience from a single institution. Ann SurgOncol. 2013, 20:1365-1373

Allen PJ, Bowne WB, Jaques DP, et al. Merkel cell carcinoma: prognosis and treatment of patients from a single institution. J ClinOncol. 2005, 23:2300-2309

Lemos BD, Storer BE, Iyer JG, 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 AcadDermatol. 2010, 63:751-761

O'Rourke MGE, Bell JR. Merkel cell tumor with spontaneous regression. J DermatolSurgOncol. 1986, 12:994-997

Connelly TJ, Cribier B, Brown TJ, et al. Complete spontaneous regression of Merkel cell carcinoma: A review of the 10 reported cases. Dermatol Surg. 2000, 26: 853-856

Tilling T, Moll I. Which are the cells of origin in merkel cell carcinoma? J Skin Cancer. 2012, 2012:680410

F, Gould V.E., Moll R., Moll I., Lee I. and Franke. W.W. Neuroendocrine (Merkel) cells of the skin: hyperplasias, dysplasias, and neoplasms. Lab Invest. 1985, 52: 334-353

Albores-Saavedra J, Batich K, Chable-Montero F, et al. Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study. J CutanPathol. 2010, 37:20-27

Heath M, Jaimes N, Lemos B, et al. Clinical characteristics of Merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features. J Am AcadDermatol. 2008, 58:375-381

Feng H, Shuda M, Chang Y, Moore PS. Clonal integration of a polyomavirus in human Merkel cell carcinoma. Science. 2008, 319:1096-1100

Stakaitytė G, Wood JJ, Knight LM, et al. Merkel cell polyomavirus: molecular insights into the most recently discovered human tumour virus. Cancers (Basel). 2014, 27: 1267-1297

Coursaget P, Samimi M, Nicol JT, et al. Human Merkel cell polyomavirus: virological background and clinical implications. APMIS. 2013, 121:755-769

Richetta A.G., Mancini M., Torroni A., et al. Total spontaneous regression of advanced merkel cell carcinoma after biopsy: review and a new case. Dermatol Surg. 2008, 34:815-822

Kubo H., Matsushita S., Fukushige T., Kanzaki T., and Kanekura T. Spontaneous regression of recurrent and metastatic Merkel cell carcinoma. J Dermatol. 2007, 34: 773-777

Turk T, Orlic ZC, Smoljan I, et al. Spontaneous regression of Merkel cell carcinoma in a patient with chronic lymphocytic leukemia: a case report. J Med Case Rep. 2009, 3:7270

Takenaka H, Kishimoto S, Shibagaki R, Nagata M, Yasuno H. Merkel cell carcinoma with partial spontaneous regression: an immunohistochemical, ultrastructural, and TUNEL labeling study. Am J Dermatopathol. 1997, 19(6):614-618

Maruo K, Kayashima KI, Ono T. Regressing Merkel cell carcinoma-a case showing replacement of tumour cells by foamy cells. Br J Dermatol. 2000, 142:1184-1189

Mori Y, Hashimoto K, Tanaka K, Cui CY, Mehregan DR, Stiff MA. A study of apoptosis in Merkel cell carcinoma: an immunohistochemical, ultrastructural, DNA ladder, and TUNEL labeling study. Am J Dermatopathol. 2001, 23:16-23


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