An 80-year-old woman with a history of lymphocytosis diagnosed 10 years ago, who did not require any treatment; hypertension treated with medication.
Three months before admission, he reported the appearance of a tumor in the right axillary region, which was progressively increasing in size, without pain or fever.
Surgical excision was decided.
During the intervention, a 10x10x5 cm tumor mass was observed, affecting the axilla, pectoralis anxillae and the axillary vein, the nervous plexus and the costal wall below the muscle.
Exeresis was performed.
Pathological anatomy study revealed diffuse scleroderma in small cells with low cytoplasm, abundant mitoses and apoptotic images.
1.
Tumor cells were positive for chromogranin, NSE, synaptophysin and showed weak positivity for AE1 and AE3, being negative for CD 45, Actin ML, Actin Me CK, E100, myelin 15 CD
It was reported as primary neuroendocrine skin carcinoma (Merkel cell carcinoma).
It was recommended to rule out primary gastrointestinal and lung involvement.
1.
Other studies performed: blood count, biochemical profile, normal except LDH 1088 U/l, CEA 7.65 U/l, Ca 125 and Ca 15.3, normal.
Chest radiography, gastroscopy and abdominal ultrasound were normal.
Dysplasia sellosa was observed in the sigmoid diverticulum and a polyp of about 2 cm in diameter at 30 cm of the anus, which was biopsied, being the result of the histology of the fragment of adenoma vell
A polypectomy was subsequently performed.
TAC-abdominal: normal.
The treatment was completed with regional radiotherapy.
