NEUROENDOCRINE SKIN CARCINOMA ASSOCIATED WITH CALCITONIN PRODUCTION - A MERKEL CELL-CARCINOMA

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  • 1 January 1980
    • journal article
    • research article
    • Vol. 11  (5) , 586-589
Abstract
An elderly woman presented with an ulcerating skin carcinoma located over the right parietal area. It healed after local radiotherapy, but recurred locally and metastasized to the subcutaneous tissue and one regional lymph node. Neurosecretory granules were demonstrated ultrastructurally and blood levels of calcitonin were repeatedly elevated. A metastasizing medullary carcinoma of the thyroid was suspected and a total thyroidectomy was performed; no medullary carcinoma or C [calcitonin secreting], cell hyperplasia could be identified. The calcitonin levels remained unchanged following thyroidectomy, whereas they decreasd twice after the skin tumor or its metastases were ablated. Clinical follow-up for > 7 yr revealed no other lesion that could have been responsible for the overproduction of calcitonin. The ultrastructural features of this skin carcinoma and its metastases, particularly the neurosecretory granules, were reminiscent of those of the so-called Merkel cell. This skin carcinoma might indeed produce calcitonin; this tumor may be derived from Merkel cells and Merkel cells may belong within the APUD [amine precursor uptake and decarboxylation] system.