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Spontaneous Regression Of Merkel Cell Carcinoma Of The Male Breast With Ongoing Immune Response

Nijjar, Y., Bigras, G., Tai, P., & Joseph, K. (2018). Spontaneous Regression of Merkel Cell Carcinoma of the Male Breast with Ongoing Immune Response. Cureus, 10(11), e3589. https://doi.org/10.7759/cureus.3589

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Abstract

Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine tumor arising predominantly on sun-exposed skin among the elderly. The most common location is the head and neck, followed by the extremities. MCCs are highly aggressive tumors and rarely undergo spontaneous regression. We report a case of MCC which presented as a painless breast lump in an elderly male where the tumor regressed spontaneously after a biopsy.

Case Details

Disease Location

Breast

Personal Characteristics

77-year-old gentleman

Clinical Characteristics

Presented with a painless left breast lump of six months duration. The lesion was subcutaneous, and skin was intact without any colour change. The patient underwent a mammogram and an ultrasound, which revealed an irregular soft tissue mass at the 12 o’clock position, measuring 2.4 x 1.4 cm. The patient underwent a core biopsy that revealed sheets of poorly differentiated malignant small blue cells at a high mitotic rate, focally demonstrating rhabdoid-type features. The immunohistochemical profile and pattern of cytokeratin staining were most in keeping with merkel cell carcinoma (mcc).

Remission Characteristics

Fdg PET/CT performed two weeks after biopsy did not show any fdg-avid lesion, except for a nonspecific uptake in multiple mediastinal lymph nodes. The tumor was staged as iia (t2n0).

Treatment & Mechanisms

Proposed Remission Mechanisms

The role of t cell-mediated immune response in the development of tumor regression resulting in apoptosis and cellular necrosis

Clinical Treatment

Biopsy

Non-Clinical Treatment

None reported