Key result
Recurrent Merkel cell carcinoma presents as a fatal ~9.5-cm cardiac mass with gastric metastasis.
Why the study?
Merkel cell carcinoma is an aggressive, rare neuroendocrine skin cancer in which metastases to the heart and stomach have each rarely been reported.
Case Report (n=1)
No
This case represents the first reported occurrence of synchronous cardiac and gastric metastases from cutaneous Merkel cell carcinoma, highlighting the utility of fluoroscopy- and ultrasound-guided cardiac biopsy for diagnosis.
Answers are grounded in this paper and cite their sources.
Raises awareness of rare cardiac metastasis in Merkel cell carcinoma recurrence; extends reported patterns but leaves optimal surveillance open.
RATIONALE: Merkel cell carcinoma (MCC) is an aggressive, rare neuroendocrine skin cancer. MCC metastasis to the heart is exceedingly rare and gastric metastases from MCC have rarely been reported. PATIENT CONCERNS: We described the case of an 82-year-old man diagnosed with recurrent MCC with cardiac and gastric metastasis who presented with poor oral intake and severe weight loss. The patient was diagnosed with MCC 3 years ago and treated with surgical resection and radiation. INTERVENTIONS: We performed stomach biopsy in edematous lesion. And fluoroscopy and ultrasound guided biopsy of the cardiac mass was performed. DIAGNOSES: MCC with synchronous metastases to the heart and stomach. OUTCOMES: The primary lesion had complete resolution and the patient remained disease free on regular follow-up every 6 months for 2 and half years. After MCC recurred, palliative anti-cancer therapy was considered but could not be performed due to the patient's poor performance status involved elderly, combined recurrent pneumonia. LESSONS: To our best knowledge, this is the first report of synchronous cardiac and gastric metastasis from cutaneous MCC worldwide. Although uncommon, MCC should be considered in clinical cases of synchronous metastasis.
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Ha et al. (2018) conducted a case report in Recurrent Merkel cell carcinoma with synchronous metastases to the heart and stomach (n=1). Palliative care following endoscopic stomach biopsy and fluoroscopy/ultrasound-guided cardiac biopsy was evaluated on Clinical outcome and survival. Cutaneous Merkel cell carcinoma recurred 3 years after initial remission with a 9.5-cm cardiac mass and diffuse gastric metastasis in an 82-year-old man, leading to death during palliative care.
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