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Skin Cancer

Skin Cancer

Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...

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Merkel Cell Polyomavirus Infection and Detection

Merkel Cell Polyomavirus Infection and Detection

Published on: February 7, 2019

Merkel Cell Carcinoma In Situ: No More Serendipity?

Candice E Brem¹, Deon Wolpowitz¹, Kyung Hee Chang²

¹Section of Dermatopathology, Department of Dermatology, Boston University School of Medicine, Boston, MA.

The American Journal of Dermatopathology

|November 2, 2021

Summary

This case report details a rare instance of Merkel cell carcinoma in situ (MCCIS) without associated squamous lesions. The findings highlight MCCIS as a distinct epidermal lesion with pagetoid spread, warranting its inclusion in diagnostic considerations.

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Area of Science:

Dermatopathology
Oncology
Skin Cancer Research

Background:

Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer.
Merkel cell carcinoma in situ (MCCIS) is an exceedingly rare precursor or intraepidermal form of MCC.
Previous reports often described MCCIS in association with squamous cell carcinoma in situ.

Observation:

A 50-year-old male with a history of sun exposure and non-melanoma skin cancers presented with a scaly papule.
Biopsy revealed atypical basaloid cells with pagetoid spread within epidermal hyperplasia.
Immunoperoxidase staining showed a focal perinuclear dot-like pattern for cytokeratin-20.

Findings:

A diagnosis of Merkel cell carcinoma in situ (MCCIS) was established after excluding other entities.
This case is unique as it lacked an associated squamous lesion, a common co-occurrence in prior MCCIS reports.
The observed pagetoid spread, while occasionally described, is an unusual feature in this context.

Implications:

This case expands the understanding of MCCIS presentation and its potential to occur independently of squamous lesions.
The findings support the classification of MCCIS as a distinct in situ epidermal lesion characterized by pagetoid spread.
Clinicians and pathologists should consider MCCIS in the differential diagnosis of unusual in situ epidermal proliferations, especially those with pagetoid features.