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Long Lasting Complete Regression Of A Metastatic Polyomavirus- Positive Merkel Cell Carcinoma After Covid-19 Booster Vaccination

Wesselmann, U., Kvasnicka, H. M., Bozkurt, A., Wieland, U., & Hofmann, S. C. (2024). Long lasting complete regression of a metastatic polyomavirus-positive Merkel cell carcinoma after COVID-19 booster vaccination. EJC Skin Cancer, 2, 100275-. https://doi.org/10.1016/j.ejcskn.2024.100275

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Abstract

Merkel cell carcinoma (MCC) is a rare but highly aggressive primary cutaneous neuroendocrine cancer whose incidence is increasing worldwide. MCC represents the second leading cause of skin cancer death after melanoma [1,2]. It typically manifests as a red nodule or plaque with fast growth, most commonly on sun exposed areas [3]. Risk factors include fair skin type, advanced age, ultraviolet radiation exposure, male sex, immunosuppression, and integration of Merkel cell polyomavirus DNA (MCPyV) into the host genome [3].

Case Details

Disease Location

Skin, lymph node

Personal Characteristics

84-year-old man

Clinical Characteristics

Three months before, he had undergone an incomplete excision of a histologically confirmed mcc on his right forearm. Within the past 8 weeks, the patient had noted a rapidly growing nodule at the primary excision site. Clinical assessment revealed a 4 × 4cm large livid-erythematous cutaneous/subcutaneous firm exophytic nodule and a mass in the right axilla. CT demonstrated a 3 cm large lymph node metastasis in the right axilla

Remission Characteristics

When the patient came back to the hospital 3 weeks later for the planned total excision of the local mcc recurrence on his right forearm and for axillary lymph node dissection, a significant reduction in size of both, the tumour on the right forearm and the mass in the right axilla, were observed and confirmed by a CT scan. The patient reported, that he had received his 3rd covid-19 mrna vaccination. Three months later, a PET-CT scan confirmed complete regression of the mcc with no tumour remnants.

Treatment & Mechanisms

Proposed Remission Mechanisms

Since the viral infection plays an important role in the pathogenesis of mcpyv-positive mcc, it is not surprising that an anti-viral im- mune response induced by vaccination may lead to regression of a virus-induced carcinoma

Clinical Treatment

Biopsy covid 19 vaccine