Ren MY, Shi YJ, Lu W, Fan SS, Tao XH, Ding Y. Facial Merkel cell carcinoma in a patient with diabetes and hepatitis B: A case report. World J Clin Cases 2023; 11(17): 4179-4186 [PMID: 37388796 DOI: 10.12998/wjcc.v11.i17.4179]
Corresponding Author of This Article
Yang Ding, MD, Doctor, Center for Plastic and Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. dingyangdoctor@163.com
Research Domain of This Article
Dermatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ming-Yang Ren, Yun-Juan Shi, School of Medicine, Graduate School of Bengbu Medical College, Bengbu 233030, Anhui Province, China
Wei Lu, Sha-Sha Fan, Xiao-Hua Tao, Yang Ding, Center for Plastic and Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Author contributions: Ren MY contributed to the methodology, investigation, wrote the original draft, wrote the review and edit; Tao XH contributed to the conceptualization and supervision; Shi YJ contributed to the literature research; Ding Y, Lu W and Fan SS contributed to the investigation, supervision and methodology; All authors contributed to the article and approved the submitted version.
Supported byThe Young Talent Project of Zhejiang Medicine and Health Science and Technology Project, No. 2022KY049 and No. 2022RC097; Zhejiang Province Public Welfare Technology Research Project, No. LGF20H110003.
Informed consent statement: This case has been completed by signing the relevant informed consent statement.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yang Ding, MD, Doctor, Center for Plastic and Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, No. 158 Shangtang Road, Hangzhou 310014, Zhejiang Province, China. dingyangdoctor@163.com
Received: April 5, 2023 Peer-review started: April 5, 2023 First decision: April 28, 2023 Revised: May 6, 2023 Accepted: May 19, 2023 Article in press: May 19, 2023 Published online: June 16, 2023 Processing time: 67 Days and 19.4 Hours
Abstract
BACKGROUND
Patients with chronic inflammatory disorders are at a higher risk of developing aggressive Merkel cell carcinoma (MCC). Diabetes is a common chronic inflammatory disease that is possibly associated with MCC; however, there are still no reports on the association between hepatitis B virus (HBV) infection and MCC. Whether there is an association between these three diseases and the specific mechanisms behind their effects is worth further research in the future.
CASE SUMMARY
We herein report a rare case of MCC with extracutaneous and nodal invasion in an Asian individual with type 2 diabetes mellitus and chronic HBV infection, but no immunosuppression or other malignancies. Such cases are uncommon and have rarely been reported in the literature. A 56-year-old Asian male presented with a significant mass on his right cheek and underwent extensive resection combined with parotidectomy, neck lymphadenectomy, and split-thickness skin grafting. Based on the histopathological findings, a diagnosis of MCC involving the adipose tissue, muscle, nerve, and parotid gland with lymphovascular invasion was made. Subsequently, he received radiotherapy with no adverse reactions.
CONCLUSION
MCC is a rare, aggressive skin cancer with frequent local recurrence, nodal invasion, and metastasis, which usually arises in older people of the white race. Patients with chronic inflammatory disorders are at a higher risk of developing aggressive MCC. The diagnosis can be confirmed with histology and immunohistochemistry. For localized MCC, surgery is the preferred treatment option. However, for advanced MCC, radiotherapy and chemotherapy have proven to be effective. In cases where chemotherapy is not effective or in the advanced stages of MCC, immune therapy plays an important role in treatment. As with any rare disease, the management of MCC remains an enormous challenge for clinicians; thus, follow-up should be individualized and future progress needs multidisciplinary collaborative efforts. Furthermore, physicians should include MCC in their list of possible diagnoses when they come across painless, rapidly growing lesions, particularly in patients with chronic HBV infection or diabetes, as these patients are more susceptible to the development of this condition and it tends to be more aggressive in them.
Core Tip: Merkel cell carcinoma in a person of the yellow race with type 2 diabetes mellitus and chronic hepatitis B virus infection but no immunosuppression or other malignancies is a rare case and has rarely been reported in the literature.
