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Case Reports in Medicine
Volume 2010, Article ID 905414, 3 pages
http://dx.doi.org/10.1155/2010/905414
Case Report

An Unusual Clinical Presentation of Merkel Cell Carcinoma: A Case Report

1Department of Pathology, Creighton University Medical Center (DPS, DEH, JC, MC), Omaha, NE 68131, USA
2Department of Dermatology (JMS), Bergan Mercy Medical Center, Omaha, NE 68124, USA

Received 26 November 2009; Revised 6 February 2010; Accepted 8 February 2010

Academic Editor: Jochen Utikal

Copyright © 2010 Deba P. Sarma et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Merkel cell carcinoma is a rare, aggressive neuroendocrine cell carcinoma arising in the sun-exposed skin of elderly patients. Most of these tumors are located in the dermis. An unusual clinical presentation of such a tumor in the subcutis, if not biopsied, may be easily mistaken as a benign lesion. Case Presentation. An 83-year-old white woman presented with a several-month history of a painless 7 mm subcutaneous mass that was initially thought to be a lipoma. A conservative follow-up was planned. At the insistence of the patient, an excisional biopsy of the mass was performed revealing a subcutaneous Merkel cell carcinoma. The tumor cells stained positively for CK 20, chromogranin, and synaptophysin. No other primary or metastatic tumors found after a thorough work-up. The patient was treated with local irradiation. She remains disease free at her six-month follow-up visit. Conclusion. When a new growth is encountered in the sun-exposed skin of elderly patients, a biopsy is warranted even if the lesion clinically appears benign.