Beata Maksymiuk(1), Andrzej Wygoda(2), Michal Zakliczynski(3), Piotr Palen(4)

Primary Undifferentiated Small Cell Carcinoma (Merkel Cell Carcinoma) in a Patient after Heart Transplantation - Case Report

1)Department of Tumour Pathology, 2)Department of Radiotherapy, Centre of Oncology, Gliwice, 3)Chair and Ward of Cardiosurgery and Transplantology, Zabrze, 4)Chair of Pathomorphology, Silesian Medical School, Katowice

Abstract

Here we report a case of a 48-year-old man after heart transplantation in whom two years after the procedure an appendage germ tumour was diagnosed and a year after its removal in the same area a primary undifferentiated small cell carcinoma (Merkel cell carcinoma) with metastases to the axillary lymph nodes was detected. The diagnosis of Merkel cell carcinoma was confirmed by immunohistochemical staining showing a typical perinuclear expression of cytokeratin 20 with the absence of reactivity with wide spectrum cytokeratin and the presence of neuroendocrine markers of neurone-specific enolase and chromogranin. Primary undifferentiated small cell carcinoma occurs more frequently in patients receiving immunosuppressive treatment as compared with a general population and occurs much more frequently in those below 50 years of age.