Neuroendocrine carcinoma of the lip (Merkel Cell tumour) examined by electron microscopy and immunohistochemistry

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Abstract
A definite diagnosis of neuroendocrine carcinoma of the skin is seldom made on initial histological examination; the tumour is usually reported as a poorly differentiated or anaplastic carcinoma. By applying electron microscopy and immunohistochemistry, a correct diagnosis can be made. The ultrastructural examination shows dense-core membrane-bound granules, intermediate perinuclear filaments and desmosome-like junctions. Immunohistochemistry reveals positive staining for neuron-specific enolase and keratin, the latter in a characteristic paranuclear distribution. Confronted with an unusual clinical picture or indefinite histological diagnosis, tissue specimens should be secured for the above mentioned ancillary procedures.