Unexpected histopathologic result of a wide surgical excision of a bleeding lesion of the skin: a case of Merkel cell carcinoma of the leg

G Chir. 2015 Sep-Oct;36(5):231-5. doi: 10.11138/gchir/2015.36.5.231.

Abstract

Background: Merkel cell Carcinoma is a very rare primary cutaneous tumor that often looks like an innocuous and asymptomatic nodule or plaque of the skin, but with a very fast growing. It is also called neuroendocrine carcinoma of the skin or trabecular cancer. The main treatment is based on a local excision followed by radiotherapy or chemotherapy. The most common site of presentation of this lesion is head and neck (40-60%.) and it often occur in older men with immunological system dysfunction like HIV patients, cancer, severe infections and immunosuppression for transplantation.

Methods: The authors report a case of a bleeding Merkel Cell Carcinoma of the right leg in a 83 years old man with HCV infection, chronic kidney disease and diabetes mellitus type 2 that required local excision.

Results: Lesion was entirely removed and then patient was sent to oncologists. After two months from surgical excision, healing process is regular and without complications.

Conclusions: This type of tumor can be misdiagnosed and, if bleeding, it can represent a serious surgical emergency.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Carcinoma, Merkel Cell / complications
  • Carcinoma, Merkel Cell / pathology*
  • Carcinoma, Merkel Cell / radiotherapy
  • Carcinoma, Merkel Cell / surgery*
  • Diabetes Mellitus, Type 2 / complications
  • Hemorrhage* / etiology
  • Hepatitis C, Chronic / complications
  • Humans
  • Hypertension / complications
  • Immunocompromised Host*
  • Leg / pathology
  • Male
  • Renal Dialysis / methods
  • Renal Insufficiency, Chronic* / therapy
  • Risk Factors
  • Skin Neoplasms / complications
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / radiotherapy
  • Skin Neoplasms / surgery*
  • Treatment Outcome