Large Intestinal Obstruction and Perforation From Metastatic Merkel Cell Carcinoma: A Case Report

Area of Science:

• Oncology
• Gastroenterology
• Dermatology

Background:

• Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer with a high metastatic potential.
• Abdominal metastases are known but typically involve regional nodal spread.

Observation:

• A 60-year-old male with a history of MCC developed a large bowel obstruction due to intraperitoneal metastases.
• A 6 cm descending colon mass, confirmed as metastatic MCC, eroded and perforated the colon wall.

Findings:

• This report describes the first documented case of colonic perforation secondary to metastatic MCC.
• The patient required emergent colectomy due to septic shock from the perforation.

Implications:

• This case underscores the critical importance of rapid, comprehensive management for patients with rapidly growing metastatic colonic tumors.
• Timely intervention is crucial for patients at risk of tumor-related complications like perforation.