Merkel cell carcinoma (Primary Neuroendocrine Carcinoma of Skin) mimicking basal cell carcinoma with review of different histopathologic features

Farah Succaria, Arash Radfar, Jag Bhawan

Research output: Contribution to journalReview articlepeer-review

Abstract

Merkel cell carcinoma (MCC) is a rare but highly aggressive malignancy, which often has typical histopathologic and immunohistochemical (IHC) features. Sometimes the diagnosis is missed because of atypical histological or aberrant IHC findings. A case of MCC that showed irregular lobules of basaloid cells with keratotic areas on the initial shave biopsy is being reported. IHC showed positive staining for high-molecular weight cytokeratin but negative staining for cytokeratin 20, findings consistent with basal cell carcinoma. Subsequent excision specimen showed histopathologic features more typical of MCC. IHC still was negative for cytokeratin 20 but positive for synaptophysin. Review of the literature shows other examples of MCC with basal cell carcinoma-like features. Various other histopathologic differentiations of MCC include those that demonstrate squamous cell and eccrine carcinoma features and those that show melanocytic, lymphomatous, sarcomatous, muscular, and atypical fibroxanthoma-like features. Different histopathologic patterns and mimics of MCC are reviewed to help prevent dermatopathologists from misdiagnosing this aggressive tumor.

Original languageEnglish (US)
Pages (from-to)160-166
Number of pages7
JournalAmerican Journal of Dermatopathology
Volume36
Issue number2
DOIs
StatePublished - Feb 1 2014
Externally publishedYes

Keywords

  • Basal cell carcinoma
  • IHC
  • Melanoma
  • Merkel cell carcinoma
  • Primary neuroendocrine carcinoma of skin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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