皮肤merkel细胞癌扁桃体转移1例并文献回顾

目的：探讨皮肤Merke!细胞癌的诊断及鉴别诊断、治疗及预后。方法：对1例皮肤Merkel细胞癌扁桃体转移患者的临床病史、肿瘤组织的病理免疫组化表达及治疗过程进行回顾性分析，并结合相关文献就其临床特征及转移方式进行讨论。结果：本例Merkel细胞癌患者表现为臀部merkel细胞癌，于术后5个月发生附近淋巴结转移，再次手术后出现远处转移。手术后2年，发现右颌下包块，咽部不适，扁桃体活检证实扁桃体小细胞神经内分泌癌；免疫组化EMA（＋）NSE（4-）CK、CgA、Vim、ICA均（-）。结论：Merkel细胞癌罕见且进展快，即使综合治疗后仍有局部复发和远处转移的倾向，预后差。诊断主要依靠病理，免疫组化染色有助于鉴别诊断。临床上需结合病史与扁桃体原发癌相鉴别。

Skin Merkel Cell Carcinoma of the Tonsillar Metastasis of 1 Case and Review of Literature

Objective： To investigate the skin Merkel cell carcinoma of the diagnosis and differential diagnosis, treatment and prognosis. Methods： 1 cases of skin Merkel cell carcinoma of the tonsil metastasis in patients with clinical history, pathological tumor tissue immunohistochemical expression and the course of treatment were analyzed retrospectively, combined with the literature on its clinical features and the transfer of methods discussed. Results：The cases of Merkel cell carcinoma patients showed hip merkel cell carcinoma, in surgery in May took place near the lymph node metastasis, distant metastasis after re -operation. 2 years after surgery and found that the right submandibular mass, pharyngeal discomfort, tonsil tonsil biopsy confirmed a small cell neuroendocrine carcinoma; try EMA （ ＋ ） NSE （ ＋ ） CK, CgA, Vim, ICA were （ - ）. Conclusions：Merkel cell carcinoma, a rare and fast progress, even after the comprehensive treatment of local recurrence and distant metastasis is still a tendency to poor prognosis. Rely mainly on diagnostic pathology, immunohistochemistry contribute to differential diagnosis. Requires a combination of clinical history and phase identification of tonsil primary cancer.