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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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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author Farees Saqlain
Sophia Z. Shalhout
Kevin S. Emerick
Tomas G. Neilan
Tatyana Sharova
David Michael Miller
author_facet Farees Saqlain
Sophia Z. Shalhout
Kevin S. Emerick
Tomas G. Neilan
Tatyana Sharova
David Michael Miller
author_sort Farees Saqlain
collection DOAJ
description 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.
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institution OA Journals
issn 2090-6463
2090-6471
language English
publishDate 2020-01-01
publisher Wiley
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series Case Reports in Dermatological Medicine
spelling doaj-art-0a5d355a04f84e94badc9ecd57ea0d002025-08-20T02:03:12ZengWileyCase Reports in Dermatological Medicine2090-64632090-64712020-01-01202010.1155/2020/88908458890845Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse EventsFarees Saqlain0Sophia Z. Shalhout1Kevin S. Emerick2Tomas G. Neilan3Tatyana Sharova4David Michael Miller5Harvard Medical School, Boston, MA, USAHarvard Medical School, Boston, MA, USAHarvard Medical School, Boston, MA, USAHarvard Medical School, Boston, MA, USADepartment of Medicine, Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA, USAHarvard Medical School, Boston, MA, USAMerkel 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.http://dx.doi.org/10.1155/2020/8890845
spellingShingle Farees Saqlain
Sophia Z. Shalhout
Kevin S. Emerick
Tomas G. Neilan
Tatyana Sharova
David Michael Miller
Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events
Case Reports in Dermatological Medicine
title Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events
title_full Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events
title_fullStr Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events
title_full_unstemmed Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events
title_short Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events
title_sort metastatic merkel cell carcinoma masquerading as multiple immune related adverse events
url http://dx.doi.org/10.1155/2020/8890845
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