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July 19, 2010

Pathology Quiz Case 2: Diagnosis

Author Affiliations

Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Otolaryngol Head Neck Surg. 2010;136(7):747-748. doi:10.1001/archoto.2010.86-b

Diagnosis: Merkel cell carcinoma (MCC) of the left auricle

Merkel cell carcinoma, which is an uncommon, aggressive cutaneous neoplasm, was first described in 1972.1Although MCCs were originally thought to originate from neuroendocrine mechanoreceptor cells, it is now believed that they are derived from pluripotent neural crest cells.2,3Nearly half of all MCCs present in the head and neck area. Facial areas, including the cheeks, nose, mouth, and eyelids, are the most common sites, while auricular MCC is extremely rare.1,4Merkel cell carcinoma exhibits rapid growth and aggressive lymphatic spread, and 25% of patients will have local or distant spread at initial presentation.2,4,5An additional 30% will develop local or distant spread during the disease course.2On physical examination, MCC lesions appear as pink or violaceous subcutaneous nodules. Ulceration is a rare finding.1,4,6