Abstract
BackgroundMerkel cell carcinoma (MCC) is an uncommon neuroendocrine cutaneous carcinoma. Metastases to the thyroid gland are rare and may present diagnostic difficulties.Case presentationA 73-year-old woman presented with a hard mass in the adipose tissue of the right inguinal area. This mass was surgically excised and the histology examination showed the existence of a MCC. CT scans revealed a sizable lesion with imaging features of a submerged goiter, invasive to the upper mediastinum. The patient received chemotherapy following by locoregional radiotherapy at the bed of the excised lesion. During the next 10 months the patient was asymptomatic, serum markers values were normal and CT scans findings were stable. However, afterwards NSE and chromogranin values raised and CT scans revealed an enlargement of the submerged goiter. The patient became symptomatic, mainly experiencing respiratory inconvenience. Surgical excision of the right lobe of the thyroid gland was decided and performed without any complications. The histopathology examination showed infiltration of the thyroid gland by a neuroendocrine carcinoma with characteristics compatible with MCC.ConclusionsThe rare case of metastatic infiltration of the thyroid gland by a MCC based on histological and immunohistochemical findings was described. This case report is of clinical significance indicating that by any abnormal finding in the thyroid gland in patients with a malignant disease, the diagnostic approach should always contain consideration of metastasis from the primary tumor.
Highlights
Merkel cell carcinoma (MCC) is an uncommon neuroendocrine cutaneous carcinoma
The rare case of metastatic infiltration of the thyroid gland by a MCC based on histological and immunohistochemical findings was described
This case report is of clinical significance indicating that by any abnormal finding in the thyroid gland in patients with a malignant disease, the diagnostic approach should always contain consideration of metastasis from the primary tumor
Summary
The rare case of metastatic infiltration of the thyroid gland by a Merkel cell carcinoma based on histological and immunohistochemical findings was described This case report is of clinical significance indicating that by any abnormal finding in the thyroid gland in patients with a malignant disease, the diagnostic approach should always contain consideration of metastasis from the primary tumor. Authors’ contributions NT: Conception and design, Collection and assembly of data, Data analysis and interpretation, Provision of study materials or patients, Manuscript writing, Final approval of manuscript. ER: Collection and assembly of data, Data analysis and interpretation, Final approval of manuscript. Author details 1Department of Medical Oncology, “401” General Military Hospital, Gennimata N. Author details 1Department of Medical Oncology, “401” General Military Hospital, Gennimata N. 10-12, 11524 Ampelokipi, Athens, Greece. 2Department of Medical Oncology, “Hippocration” General Hospital, Athens, Greece. 3Department of Clinical Therapeutics, "Alexandra" Hospital, University of Athens School of Medicine, Athens, Greece. 4Department of Pathology, “Evaggelismos” General Hospital, Athens, Greece
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