Merkel 세포암
Merkel Cell Carcinoma
권기환, 심효섭, 김봉수, 박세호, 김태성, 신규호, 김충배, 김순일, 김유선, 박기일,
소속 상세정보
권기환 ( Kwon Ki-Hwan )
연세대학교 의과대학 외과학교실
심효섭 ( Shim Hyo-Sup )
연세대학교 의과대학 병리학교실
김봉수 ( Kim Bong-Soo )
연세대학교 의과대학 외과학교실
박세호 ( Park Se-Ho )
연세대학교 의과대학 외과학교실
김태성 ( Kim Tae-Seung )
연세대학교 의과대학 병리학교실
신규호 ( Shin Kyoo-Ho )
연세대학교 의과대학 정형외과학교실
김충배 ( Kim Choong-Bai )
연세대학교 의과대학 외과학교실
김순일 ( Kim Soon-Il )
연세대학교 의과대학 외과학교실
김유선 ( Kim Yu-Seun )
연세대학교 의과대학 외과학교실
박기일 ( Park Ki-Il )
연세대학교 의과대학 외과학교실
KMID : 0371320020630060498
Abstract
PURPOSE: The incidence of malignancies after an organ transplant has steadily increased along with a significant improvement of the long-term recipient survival. Eighty-seven variable post-transplant malignancies out of 2,140 renal transplantations were
encountered at Yonsei University Medical Center. Among them, we recently experienced a Merkel cell carcinoma (MCC), a rare malignancy originates from neuro-endocrine cells. Herein, we report 6 MCC cases including 5 that developed in non-transplant
patients. METHODS: The medical records of 6 patients who have been diagnosed with a MCC since 1984 were reviewed. RESULTS: There were four males and two females. The mean age at the time of diagnosis was 57.7 (48~65). Five cases were a primary MCC and
one was secondary in nature that was related to long-term immunosuppression after a kidney transplant. The extremities (n=3), the head and the neck (n=2) were the prevalent sites for MCC. Four patients are currently alive after mean follow-up of 33.3
months (2~67). The secondary case was a MCC that developed in a 49 years old male patient 16 years after receiving a living donor renal transplant. He noticed a mass on the antero-lateral side of the left thigh 1 month before admission. The mass was
soft, round, red-violet in color and measured 5 cm in diameter. With 5 mm of skin margin, the mass was completely excised and was found to be a MCC. To rule out loco-regional and distant metastasis, thoraco-abdomino-pelvic CT scan was taken which showed
no evidence of abnormal images. Considering the aggressive biological nature of the MCC, we radically excised more skin and muscular fascia, but no remnant malignant cells were found by pathology. CONCLUSION: MCC presents as a dermal mass mostly at the
head, neck, and the extremities with characteristics of rapid aggressive metastasis and recurrence. Wide excision with a 3 cm margin is recommended in patients without a metastasis. This is the first report of a MCC after a renal transplantat in
Korea.
키워드
Merkel 세포암; 신장이식; Merkel cell carcinoma; Renal transplantation;
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