Open AccessPrimary Merkel cell carcinoma of the oral mucosa in a young adult male: Report of a rare case
Author(s) -
Sayak Roy,
Indranil Das,
Ayandip Nandi,
Rakesh Roy
Publication year - 2015
Publication title -
indian journal of pathology and microbiology/indian journal of pathology and microbiology
Language(s) - English
Resource type - Journals
eISSN - 0974-5130
pISSN - 0377-4929
DOI - 10.4103/0377-4929.155318
Subject(s) - synaptophysin , merkel cell carcinoma , vincristine , neuroendocrine differentiation , cd99 , pathology , medicine , cytokeratin , biopsy , chemotherapy , cyclophosphamide , carcinoma , immunohistochemistry , cancer , surgery , vimentin , prostate cancer
Merkel cell carcinoma (MCC) is a highly aggressive neoplasm of skin with neuroendocrine differentiation. Primary MCC of the oral mucosa is exceedingly rare and even more unresponsive to therapy. A 15-year-old male presents with gradually increasing painless swelling in right side of the floor of mouth for 6 weeks. Computed tomography of head and neck region showed globular mass (4.6 cm × 1.7 cm) involving right side of the floor of mouth. Fine-needle aspiration from the upper deep cervical node suggested small round cell tumor. A trucut biopsy showed mass composed of trabeculae and nests of tumor cells with high N:C ratio, granular speckled chromatin, scanty to moderate amount of clear vacuolated cytoplasm. Cells were immunoreactive for cytokeratin-20, CD56, c-kit, CD99 and negative for p63, thyroid-transcription factor-1, CDX2, synaptophysin, neuron-specific enolase. Patient was started on chemotherapy with cyclophosphamide, doxorubicin and vincristine. The mass regressed in size and patient underwent wide local excision with pull-through approach. Patient is currently under combined chemoradiation regime and doing well.