Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events

Merkel cell carcinoma is a rare cutaneous neuroendocrine carcinoma with a high rate of regional and distant metastasis and mortality. Here, we report a novel case of Merkel cell carcinoma which presented as a primary lesion to the left cheek with regional lymph node involvement and was treated with...

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Bibliographic Details
Main Authors: Farees Saqlain, Sophia Z. Shalhout, Kevin S. Emerick, Tomas G. Neilan, Tatyana Sharova, David Michael Miller
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Dermatological Medicine
Online Access:http://dx.doi.org/10.1155/2020/8890845
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Summary:Merkel cell carcinoma is a rare cutaneous neuroendocrine carcinoma with a high rate of regional and distant metastasis and mortality. Here, we report a novel case of Merkel cell carcinoma which presented as a primary lesion to the left cheek with regional lymph node involvement and was treated with pembrolizumab and radiation. Widely metastatic disease eventually revealed on autopsy clinically mimicked immune-related organ insult leading to management with immunosuppressants. The patient also had a biopsy-confirmed immune-related cutaneous adverse event during admission. The case highlights a rare circumstance in which disease progression masqueraded as multiple immune-related end-organ adverse events. Contribution of on-target anti-PD-1 toxicity remains a possibility.
ISSN:2090-6463
2090-6471