Advertisement

European Archives of Oto-Rhino-Laryngology

, Volume 248, Issue 8, pp 436–441 | Cite as

Merkel cell carcinoma of the head and neck associated with Bowen's disease

  • P. Schenk
  • K. Konrad
Original Investigations

Summary

The Merkel cell carcinoma occurs primarily in the skin of the head and neck, and develops in the dermis with a trabecular growth pattern. Immunohistochemistry reveals positive staining for neuron-specific enolase, neurofilaments, cytokeratin and chromogranin A. Electron microscopically, the tumor cells contain dense-core granules, spinous cytoplasmic processes, desmosomes, zonulae adherentes and paranuclear filament aggregates besides frequent mitoses, focal necroses and lymphocyte and plasma cell infiltrates. The Merkel cell carcinoma is often co-existent with other malignancies such as squamous cell carcinoma or, as in the present study, with Bowen's disease. The definite diagnosis of the Merkel cell carcinoma can be effected only by electron microscopic examination of the tumor.

Key words

Merkel cell carcinoma Neuroendocrine carcinoma Bowen's disease Immunohistochemistry Electron microscopy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Boysen M, Wetteland P, Hovig T, Brandtzaeg P (1989) Neuroendocrine carcinoma of the lip (Merkel cell tumour) examined by electron microscopy and immunohistochemistry. J Laryngol Otol 103:519–523Google Scholar
  2. 2.
    Breathnach AS (1971) Embryology of human skin. J Invest Dermatol 57:133–143Google Scholar
  3. 3.
    Ghadially FN (1988) Ultrastructural pathology of the cell and matrix, 3rd edn. Butterworths, London, p 413Google Scholar
  4. 4.
    Goepfert H, Remmler D, Silva E, Wheeler B (1984) Merkel cell carcinoma (endocrine carcinoma of the skin) of the head and neck. Arch Otolaryngol 110:707–712Google Scholar
  5. 5.
    Gomez LG, DiMaio S, Silva EG, Mackay B (1983) Association between neuroendocrine (Merkel cell) carcinoma and squamous carcinoma of the skin. Am J Surg Pathol 7:171–177Google Scholar
  6. 6.
    Gould VE, Moll R, Moll I, Lee I, Franke WW (1985) Neuroendocrine (Merkel) cells of the skin: hyperplasias, dysplasias, and neoplasms. Lab Invest 52:334–353Google Scholar
  7. 7.
    Groh V, Tani M, Harter A, Wolff K, Stingl G (1986) Leu-3/T4 expression on epidermal Langerhans cells in normal and diseased skin. J Invest Dermatol 86:115–120Google Scholar
  8. 8.
    Groh V, Gadner H, Radaszkiewicz T, Rappersberger K, Konrad K, Wolff K, Stingl G (1988) The phenotypic spectrum of histiocytosis X. J Invest Dermatol 90:441–447Google Scholar
  9. 9.
    Hanke CW, Conner AC, Temofeew RK, Lingeman RE (1989) Merkel cell carcinoma. Arch Dermatol 125:1096–1100Google Scholar
  10. 10.
    Hanna GS, Ali MH, Akosa AB, Maher EJ (1988) Merkel-cell carcinoma of the pina. J Laryngol Otol 102:608–611Google Scholar
  11. 11.
    Hartschuh W, Weihe E, Egner U (1989) Chromogranin A in the mammalian Merkel cell: cellular and subcellular distribution. J Invest Dermatol 93:641–648Google Scholar
  12. 12.
    Hashimoto K (1972) The ultrastructure of the skin of embryos. X. Merkel tactile cells in the finger and nail. J Anat 11:99–120Google Scholar
  13. 13.
    Heenan PJ, Cole JM, Spagnolo DV (1990) Primary cutaneous neuroendocrine carcinoma (Merkel cell tumor). An adnexal epithelial neoplasm. Am J Dermatopathol 12:7–16Google Scholar
  14. 14.
    Hitchcock CL, Bland KI, Laney RG, Franzini D, Harris B, Copeland EM (1988) Neuroendocrine (Merkel cell) carcinoma of the skin: its natural history, diagnosis, and treatment. Ann Surg 207:201–207Google Scholar
  15. 15.
    Hoefler H, Kerl H, Rauch HJ, Denk H (1984) New immunocytochemical observations with diagnostic significance in cutaneous neuroendocrine carcinoma. Am J Dermatopathol 6:525–530Google Scholar
  16. 16.
    Knox SJ, Kapp DS (1988) Hyperthermia and radiation therapy in the treatment of recurrent Merkel cell tumors. Cancer 62:1479–1486Google Scholar
  17. 17.
    Leff EL, Brooks JSJ, Trojanowski JQ (1985) Expression of neurofilament and neuron-specific enolase in small cell tumors of skin using immunohistochemistry. Cancer 56:625–631Google Scholar
  18. 18.
    Lever WF (1990) Histopathology of the skin, 7th edn. Lippincott, Philadelphia, p 549Google Scholar
  19. 19.
    Marks ME, Kim RY, Salter MM (1990) Radiotherapy as an adjunct in the management of Merkel cell carcinoma. Cancer 65:60–64Google Scholar
  20. 20.
    Meland NB, Jackson IT (1986) Merkel cell tumor: diagnosis, prognosis and management. Plast Reconstruct Surg 77:632–638Google Scholar
  21. 21.
    Merkel F (1875) Tastzellen und Tastkörperchen bei den Haustieren und beim Menschen. Arch Mikr Anat 11:636–652Google Scholar
  22. 22.
    Merot Y, Margolis RJ, Dahl D, Saurat JH, Mihm MC (1986) Coexpression of neurofilament and keratin proteins in cutaneous neuroendocrine carcinoma cells. J Invest Dermatol 86:74–77Google Scholar
  23. 23.
    Moll I, Moll R, Franke WW (1986) Formation of epidermal and dermal Merkel cells during fetal skin development. J Invest Dermatol 87:779–787Google Scholar
  24. 24.
    Nelson EL, Houghton DC (1990) Concurrent spindle cell peripheral pulmonary carcinoid tumor and Merkel cell tumor of the skin. Arch Pathol Lab Med 114:420–423Google Scholar
  25. 25.
    Raaf JH, Urmacher C, Knapper WK, Shin MH, Cheng EWK (1986) Trabecular (Merkel cell) carcinoma of the skin. Treatment of primary, recurrent, and metastatic disease. Cancer 57:178–182Google Scholar
  26. 26.
    Rocamora A, Badia N, Vives R, Carrillo R, Ulloa J, Ledo A (1987) Epidermotropic primary neuroendocrine (Merkel cell) carcinoma of the skin with Pautrier-like microabscesses. J Am Acad Dermatol 16:1163–1168Google Scholar
  27. 27.
    Schenk P (1975) Melanocyten, Langerhanssche und Merkelsche Zellen in oralen Epithelien. Acta Otolaryngol (Stockh) 80:301–311Google Scholar
  28. 28.
    Sibley RK, Dahl D (1985) Primary neuroendocrine (Merkel cell?) carcinoma of the skin. II. An immunocytochemical study of 21 cases. Am J Surg Pathol 9:109–116Google Scholar
  29. 29.
    Sibley RK, Rosai J, Foucar E, Dehner LP, Bosl G (1980) Neuroendocrine (Merkel cell) carcinoma of the skin. Am J Surg Pathol 4:211–221Google Scholar
  30. 30.
    Sibley RK, Dehner LP, Rosai J (1985) Primary neuroendocrine (Merkel cell?) carcinoma of the skin. A clinicopathologic and ultrastructural study of 43 cases. Am J Surg Pathol 9:95–108Google Scholar
  31. 31.
    Sidhu GS, Feiner H, Flotte TJ, Mullins JD, Schaefler K, Schultenover SJ (1980) Merkel cell neoplasms. Histology, electron microscopy, biology, and histogenesis. Am J Dermatopathol 2:101–119Google Scholar
  32. 32.
    Silva EG, MacKay B, Goepfert H, Burgess MA, Fields RS (1984) Endocrine carcinoma of the skin (Merkel cell carcinoma). Pathol Ann 19:1–30Google Scholar
  33. 33.
    Tang CK, Toker C (1978) Trabecular carcinoma of the skin. An ultrastructural study. Cancer 42:2311–2321Google Scholar
  34. 34.
    Toker C (1972) Trabecular carcinoma of the skin. Arch Dermatol 105:107–110Google Scholar
  35. 35.
    Warner TFCS, Uno H, Hafez GR, Burgess J, Bolles C, Lloyd RV, Oka M (1983) Merkel cells and Merkel cell tumors. Cancer 52:238–245Google Scholar
  36. 36.
    Weidauer H, Altmannsberger HM (1987) Das neuroendokrine Karzinom (Merkelzelltumor) im Kopf-Hals-Bereich. Strahlenther Onkol 163:529–533Google Scholar
  37. 37.
    Winkelmann RK (1977) The Merkel cell system and a comparison between it and the neurosecretory or APUD cell system. J Invest Dermatol 69:41–46Google Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • P. Schenk
    • 1
  • K. Konrad
    • 2
  1. 1.Department of Otorhinolaryngology IIUniversity of Vienna Medical SchoolViennaAustria
  2. 2.Department of Dermatology IUniversity of Vienna Medical SchoolViennaAustria

Personalised recommendations