phenylephrine-hydrochloride and Carcinoma--Merkel-Cell

The aim of this study was to perform a systematic literature review of Merkel cell carcinomas (MCCs) originating exclusively in the ear, nose and throat (ENT) district. An appropriate string was run on PubMed to retrieve articles dealing with ENT presentations of MCC. A double cross-check was performed on citations and full-text articles found using the selected inclusion and exclusion criteria. In total, 43 articles were finally included in the study, describing 51 cases of MCC involving the ENT region: 22/51 (43%) cases involving the ear; 20/51 (39%) cases involving the mucosal sites; 9/51 (18%) cases involving other ENT regions. Patients with mucosal site involvement showed a higher mortality rate from the disease (45%) in comparison with the other two groups, especially when compared with those patients having primary involvement of the ear (22%). The ENT specialist should suspect and consider MCC, especially in elderly patients presenting with a suspicious lesion of the auricular pavilion, so as to avoid misdiagnosis and delayed treatments.

Topics: Carcinoma, Merkel Cell; Ear; Humans; Mucous Membrane; Nose; Otorhinolaryngologic Neoplasms; Parotid Gland; Parotid Neoplasms; Pharynx; Skin Neoplasms

Merkel cell carcinoma (MCC) is an uncommon, potentially lethal, cutaneous tumor that mainly occurs in sun-exposed skin of the head and neck area of the elderly. We report a case of MCC presenting as a 2-mm crusted erosion on the nose of an elderly patient, the smallest MCC reported thus far in the literature. The optimal management of MCC has not been clearly established. In view of its high local recurrence rate, predilection to metastasis, and significant mortality, aggressive treatment has been advocated. Identification of this tumor at such a small size posed a management dilemma because of lack of prospective treatment data involving biologic markers of prognostic significance for MCC.

Topics: Aged; Biopsy; Carcinoma, Merkel Cell; Dermatologic Surgical Procedures; Humans; Immunohistochemistry; Male; Mohs Surgery; Nasal Mucosa; Nose; Nose Neoplasms; Skin; Skin Neoplasms

Topics: Aged; Aged, 80 and over; Carcinoma, Merkel Cell; Female; Humans; Merkel cell polyomavirus; Nose; Polymerase Chain Reaction

Topics: Biopsy; Carcinoma, Basal Cell; Carcinoma, Merkel Cell; Humans; Male; Middle Aged; Mohs Surgery; Nose; Skin Neoplasms

Merkel cell carcinoma (MCC) is a rare but more lethal cutaneous cancer than melanoma. However, spontaneous regression of a number of MCC has been reported, although the cause of this regression remains unclear. In most cases, MCC regresses after a surgical procedure, for example, biopsy. Herein, we report a case of Merkel cell polyomavirus-negative MCC coincident with squamous cell carcinoma (SCC) that underwent true spontaneous regression without biopsy. One month after the patient's first visit, clinical examination revealed that the tumor had not grown, but its surface showed changes in texture and color. Histopathologically, the excised specimen was indicative of MCC coincident with SCC and showed extensive necrosis in the upper portion of the tumor, numerous caspase-3-positive apoptotic cells, an accumulation of CD68-positive foam cells and vascular invasion. These findings suggested that the tumor had regressed. We hypothesize that extensive coagulative necrosis resulting from an insufficient local blood supply triggered the shedding of some products or components of MCC and SCC, which in turn induced antitumor immunity against both lesions.

Topics: Aged, 80 and over; Biopsy; Carcinoma, Merkel Cell; Carcinoma, Squamous Cell; Female; Humans; Margins of Excision; Merkel cell polyomavirus; Neoplasm Regression, Spontaneous; Neoplasms, Multiple Primary; Nose; Skin; Skin Neoplasms

A variety of flaps are available to cover skin defects after surgery or trauma in the head and neck area. The bilobed flap is a double transposition flap commonly used in reconstruction of small-to-medium skin defects of the face where skin is less mobile. However, larger defects can also be effectively treated with a bilobed flap in certain cases. The classic indication to cover a small defect on the nose and covering a large skin-defect after tumour resection in the jugular notch. After sufficient mobilization, the defects could easily be closed with no wound complications and with very good aesthetic and functional outcome. The bilobed flap, as a local flap, is possible in suitable locations even for larger skin defects. In addition to the simplicity of the procedure, good aesthetic results can be expected.

Topics: Aged; Carcinoma, Merkel Cell; Female; Humans; Middle Aged; Neck; Nose; Plastic Surgery Procedures; Surgical Flaps; Treatment Outcome

Topics: Aged, 80 and over; Biopsy; Carcinoma, Merkel Cell; Diagnosis, Differential; Disease Progression; Humans; Male; Nose; Positron-Emission Tomography; Skin Neoplasms

A case of a feline Merkel cell tumour is described. An 8-year-old, female cat developed a round, alopecic, reddish mass on the nose. Wide excisional surgery was performed with cartilage resection. Histologically the mass was composed of solid islands of mostly basophilic densely packed cells with a scant cytoplasm, which was suggestive of a neuroendocrine origin. Results of immunohistochemical studies using antibodies against neurone-specific enolase, chromogranin, synaptophysin and pan-cytokeratin allowed classification of the lesion as a Merkel cell tumour. Ultrastructurally, dense core granules were identified in the cytoplasm. In a 2-year follow-up no relapses or metastases were observed. The clinical course recorded is in contrast with the malignant nature of a Merkel cell tumour recently described in a cat and of the human Merkel cell tumour, but is similar to the course of the canine Merkel cell tumour which is often benign. Early diagnosis along with the use of wide surgical excision might be considered an important factor in preventing relapse of this tumour.

Topics: Animals; Carcinoma, Merkel Cell; Cat Diseases; Cats; Diagnosis, Differential; Female; Immunohistochemistry; Nose; Skin Neoplasms

Cutaneous neuroendocrine carcinoma, first described in 1972, is an aggressive disease usually occurring in sun-exposed skin. Other sites have been described, however; such tumors occasionally occur within the nasal fossa. A high rate of metastasis (>30%) explains the poor prognosis. Descriptions of the imaging features of these tumors, mainly located in cutaneous region, are rare. We therefore present the imaging features of two cases of Merkel cell carcinoma involving the sinonasal region, suggestive of a hypervascular tumor.

Topics: Aged; Aged, 80 and over; Carcinoma, Merkel Cell; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Neovascularization, Pathologic; Nose; Nose Neoplasms; Tomography, X-Ray Computed; Turbinates

Topics: Aged; Aged, 80 and over; Carcinoma, Merkel Cell; Diagnosis, Differential; Erythema; Female; Humans; Nose; Skin Neoplasms

A 90 year old woman presented with a rapidly growing nodular tumor at the tip of the nose. Clinically, keratoakanthoma was tentatively diagnosed. Histological examination, however, revealed Merkel cell carcinoma. This case supports the necessity of a surgical excision with a subsequent histological examination even when the clinical aspect is suggestive for keratoacanthoma.

Topics: Aged; Aged, 80 and over; Carcinoma, Merkel Cell; Diagnosis, Differential; Female; Humans; Keratoacanthoma; Neoplasm Recurrence, Local; Nose; Nose Neoplasms

Specimens from the reconstructed eyelids of two out of 15 patients operated on using an island chondromucosal flap from the nose were observed under light and scanning electron microscopy (EM) to study the histological and ultrastructural features of nasal epithelium transferred as a flap to the lids, the microscopic appearance of the other tissues of the flap, and its vascularisation. Both light and scanning EM images showed that nasal epithelium, when transferred as part of a flap for reconstruction of the eyelid, maintains its differentiation for many months. The lumen of arteries and veins can be observed in sagittal sections within the flap, suggesting that their course is parallel to its long axis. The absence of fibrosis or muscle fibre degeneration together with a highly cellular cartilage are indirect indications of good vascularity. These data support the reliability of the island chondromucosal flap from the nose in reconstruction of the eyelid.

Topics: Aged; Blepharoplasty; Carcinoma, Basal Cell; Carcinoma, Merkel Cell; Cartilage; Eyelid Neoplasms; Eyelids; Female; Humans; Male; Microscopy, Electron; Muscles; Nose; Surgical Flaps