Merkel cell polyomavirus on primary Merkel cell carcinoma of the skin with partial regression after biopsy

Merkel cell polyomavirus on primary Merkel cell carcinoma of the skin with partial regression after biopsy

Irene Moysset,MD (*), Juan Carlos Arias, MD (**); Beatriz Bellosillo, MD; PhD (***)

Department of Pathology (*), General Surgery (**) Consorci Sanitari Integral, L’Hospitalet de Llobregat. Department of Pathology and Molecular Biology (***) Hospital del Mar. Spain.

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Introduction: Merkel cell carcinoma (MCC) is an uncommon primary cutaneous tumour. The majority of these tumour (about 80%) have integration of the polyomavirus DNA into the genome of Merkel cell carcinoma. Reports about at least nine cases of partial regression in primary and or metastatic lesions have been published. It is likely that regression is an immunological response mediated by T cells.

Case Report: We report an 81year old woman who presented with a rapidly growing tumor in the left thigh. An incisional biopsy of the lesion was performed. Histopathologic and immunohistochemically diagnosis were consistent with Merkel cell carcinoma. Scant peritumoral lymphocytic infiltrate was CD3+, CD4+, and scant CD8+ was observed. The reporter test polymerase chain reaction (PCR) for Merkel virus yielded a positive result. Twenty days after the initial biopsy the lesion began to regress.

Conclusion: Merkel cell carcinoma is a rare and aggressive tumour. At least nine cases of partial regression on primary and or metastatic lesions have been published. It is likely that regression is a T cell-mediated immunological response. A reporter test (PCR) for Merkel virus and both types of lymphocytic infiltrate and distribution (intratumoral and peritumoral) in our case very important as there are several known mechanisms that can contribute to cellular immune escape in MCP y V positive Merkel cell carcinoma. Study of integration and regulation of the immunological system implies future development of individually of different immunological therapies.

Keywords: Skin, Merkel cell polyomavirus, Merkel cell carcinoma, partial regression, biopsy

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Irene Moysset, Juan Carlos Arias, Beatriz Bellosillo. Merkel cell polyomavirus on primary Merkel cell carcinoma of the skin with partial regression after biopsy. International Journal of Case Reports, 2020 4:129. DOI: 10.28933/ijcr-2020-04-1405


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