Criteria for the diagnosis of primary endocrine carcinoma of the skin (merkel cell carcinoma). A histological, immunohistochemical and ultrastructural study of 13 cases

Carcinoids are neuroendocrine tumors that may arise within any organ, although they are more commonly found in the gastrointestinal tract and in the bronchopulmonary tract. They are generally characterized by an indolent clinical course but may in some instances metastatise to regional lymph nodes or to distant sites. We herein describe a rather infrequent case of a 60-year-old man with a skin metastasis from a typical carcinoid of the lung. We discuss the histopathological and immunohistochemical features in the context of previous literature and comment issues related to difficulties in the differential diagnosis. Dermatopathologists should be familiar with the metastatic carcinoid profile in order to avoid potential misdiagnoses and to properly address the patient management when the skin metastasis represents the first manifestation of an internal disease.

Skin metastasis from typical carcinoid tumor of the lung.

:Carcinoid tumors are derived from neuroendocrine cells, and are most frequently found in the gastrointestinal tract and bronchopulmonary system. Cutaneous involvement of carcinoid tumors is relatively rare, with isolated case reports in the literature. We detail a patient with stage IV pulm

Atypical carcinoid metastasis to the skin.

Objective: Metastatic cutaneous neoplasms may be difficult to differentiate from primary cutaneous neoplasms. Herein, we report an unusual case of metastatic cutaneous carcinoid tumor mimicking an adnexal poroid neoplasm.



Methods:  A 53-year-old male man presented with a neoplasm on the vertex of the scalp, clinically resembling a pigmented basal cell carcinoma.



Results:  A shave biopsy was suggestive of an apocrine poroma, however, a metastatic carcinoma could not be excluded. After acquiring additional clinical information and the complete excision of the neoplasm, further immunohistochemical stains supported the diagnosis a metastatic carcinoid tumor.



Conclusion:  To our knowledge, this is the first case of metastatic carcinoid tumor reported that has mimicked a poroid neoplasm.

Metastatic cutaneous carcinoid tumor mimicking an adnexal poroid neoplasm.

Carcinoid tumors are uncommon neoplasms of neuroendocrine origin that generally arise in the gastrointestinal or bronchopulmonary tracts and typically are characterized by an indolent clinical course. Metastases from these primary neoplasms more commonly affect the viscera, with rare reports of cutaneous metastases to the skin. We report the case of a patient with a cutaneous carcinoid metastasis that was incidentally brought to our attention because of the exquisite tenderness of the lesion. A brief review of the literature also is provided.

Cutaneous metastasis of a pulmonary carcinoid tumor.

Tissue from the cutaneous metastases of bronchial carcinoid was examined. Fine argyrophil secretory granules were demonstrated in the cytoplasm of the abnormal cells which showed positive labelling with neuron-specific enolase. Ultrastructural studies revealed numerous electron-dense membrane bound neuro-secretory granules, 50-300 nm in diameter. Other characteristic features included inter-digitating pseudo pod-like processes (up to 2 mu in size) in the cytoplasmic membrane, perinuclear filaments, a well-defined Golgi zone and numerous large mitochondria.

Ultrastructural features of metastatic cutaneous carcinoid

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Ultrastructural features of metastatic cutaneous carcinoid