Mixed Merkel cell carcinoma and squamous cell carcinoma of the skin

Four mixed Merkel cell and squamous cell carcinomas of the skin are described. The patients ranged in age from 74 to 90 years and demonstrated or had a history of previous ultraviolet or infrared damage to the skin, manifested by basal cell carcinoma, squamous cell carcinoma, actinic keratoses, sola...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 1998-11, Vol.39 (5), p.882-887
Main Authors: Iacocca, Mary V., Abernethy, John L., Stefanato, Catherine M., Allan, Anne E., Bhawan, Jag
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Carcinoma, Basal Cell - pathology
Carcinoma, Merkel Cell - pathology
Carcinoma, Squamous Cell - pathology
Cell Nucleus - pathology
Cytoplasm - pathology
Dermatology
Elastic Tissue - pathology
Erythema - pathology
Female
Humans
Infrared Rays - adverse effects
Keratins - analysis
Keratosis - pathology
Male
Medical sciences
Mitosis
Neoplasms, Multiple Primary - pathology
Skin Aging - pathology
Skin Neoplasms - pathology
Tumors of the skin and soft tissue. Premalignant lesions
Ultraviolet Rays - adverse effects
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Summary:Four mixed Merkel cell and squamous cell carcinomas of the skin are described. The patients ranged in age from 74 to 90 years and demonstrated or had a history of previous ultraviolet or infrared damage to the skin, manifested by basal cell carcinoma, squamous cell carcinoma, actinic keratoses, solar elastosis, and erythema ab igne. Light microscopic examination of all 4 cases revealed invasive neoplasms consisting of 2 distinct but admixed cell types. The predominant cell type was consistent with Merkel cell carcinoma and was characterized by scant cytoplasm, a small dark polygonal nucleus with granular chromatin, a high mitotic rate, and cytokeratin 20 positivity. In each case, the Merkel cell component merged with a cytokeratin 20 negative squamous component characterized by abundant eosinophilic cytoplasm, intercellular bridges, and keratinization with focal squamous pearl formation. Immunohistochemical staining patterns were consistent with the usual pattern for that cell type; transitional cells were not demonstrated. The intimate admixture of the 2 antigenically different neoplastic cell types, and common etiologic role of ultraviolet and possibly infrared damage, lend support to the theory that some Merkel cell carcinomas and squamous cell carcinomas may arise from a pluripotent epidermal stem cell. (J Am Acad Dermatol 1998;39:882-7.)
ISSN:0190-9622
1097-6787
DOI:10.1016/S0190-9622(98)70372-X