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Clinical and dermoscopic features of combined cutaneous squamous cell carcinoma (SCC)/neuroendocrine [Merkel cell] carcinoma (MCC).
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2015 Dec; Vol. 73 (6), pp. 968-75. Date of Electronic Publication: 2015 Oct 02. - Publication Year :
- 2015
-
Abstract
- Background: Merkel cell carcinoma (MCC) is a neuroendocrine carcinoma, associated with Merkel cell polyomavirus. MCC admixed with squamous cell carcinoma (SCC) is unassociated with polyomavirus, and is genetically distinct.<br />Objective: We sought to distinguish clinically and dermoscopically between MCC and SCC/MCC.<br />Methods: We compared patient data for SCC/MCC (n = 26) and MCC (n = 20), and reviewed clinical and dermoscopic images (n = 9) of SCC/MCC.<br />Results: Patients with SCC/MCC were older (median 76.5 vs 69 years) and more often male (77% vs 60%), and had more nonmelanoma skin cancer (85% vs 25%), malignant extracutaneous tumors (25% vs 5%), lymphoproliferative disorders (23% vs 10%), and immunodeficient/proinflammatory states (77% vs 35%). In all, 58% of SCC/MCC versus 10% of MCC were clinically diagnosed nonmelanoma skin cancer. Patients with SCC/MCC had more metastases (77% vs 40%), more treatment failures (53% vs 45%), shorter survival (41 vs 54 months), and more death from disease (50% vs 40%). SCC/MCC demonstrated marked scale (7/9), and telangiectasia (1/9). Dermoscopically, small dotted and short linear irregular peripheral vessels and central milky-red areas with large-diameter arborizing vessels were seen.<br />Limitations: The rarity of SCC/MCC limits available data.<br />Conclusions: SCC/MCC is aggressive, arising within elderly patients' chronically ultraviolet-exposed skin, often in the setting of immunosuppression or inflammation. Dermoscopically, polymorphous vessels in lesions suspicious for nonmelanoma skin cancer are suggestive.<br /> (Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Age Factors
Aged
Aged, 80 and over
Biopsy, Needle
Carcinoma, Merkel Cell diagnosis
Carcinoma, Merkel Cell mortality
Carcinoma, Squamous Cell diagnosis
Carcinoma, Squamous Cell mortality
Databases, Factual
Female
Humans
Immunohistochemistry
Male
Middle Aged
Neoplasm Invasiveness pathology
Neoplasm Staging
Neoplasms, Multiple Primary diagnosis
Neoplasms, Multiple Primary mortality
Prognosis
Retrospective Studies
Risk Assessment
Sex Factors
Skin Neoplasms diagnosis
Skin Neoplasms mortality
Survival Rate
Treatment Outcome
Carcinoma, Merkel Cell pathology
Carcinoma, Squamous Cell pathology
Dermoscopy methods
Neoplasms, Multiple Primary pathology
Skin Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 73
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 26433246
- Full Text :
- https://doi.org/10.1016/j.jaad.2015.08.041