A case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma
Abstract Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy of the skin characterized by high aggressiveness. Four main factors are implicated in its development: immunosuppression, ultraviolet radiation, age and the Merkel cell polyomavirus (MCPyV). In recent years, immune c...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-10-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12885-018-4919-z |
| _version_ | 1819050804997259264 |
|---|---|
| author | Daniele Lavacchi Stefania Nobili Marco Brugia Agnese Paderi Sara Fancelli Enrico Caliman Federica Vergoni Enrico Mini |
| author_facet | Daniele Lavacchi Stefania Nobili Marco Brugia Agnese Paderi Sara Fancelli Enrico Caliman Federica Vergoni Enrico Mini |
| author_sort | Daniele Lavacchi |
| collection | DOAJ |
| description | Abstract Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy of the skin characterized by high aggressiveness. Four main factors are implicated in its development: immunosuppression, ultraviolet radiation, age and the Merkel cell polyomavirus (MCPyV). In recent years, immune checkpoint inhibitors have shown clinical activity in MCC treatment. Case presentation We report the case of an 82-year-old man with a lung adenocarcinoma diagnosis, who underwent immunotherapy with nivolumab as second-line treatment. Seven months after the diagnosis of lung cancer during the nivolumab treatment, the patient developed an eyelid MCC, initially misdiagnosed as a chalazion. A palliative radiotherapy was performed with clinical benefit. After a total of seven cycles of nivolumab, computed tomography showed a lung and cerebral disease progression. In addition, clinical conditions worsened leading to the patient’s death 13 months after the initial lung cancer diagnosis. Conclusions Cases of co-occurrence of MCC and non-small cell lung cancer (NSCLC) have rarely been reported. Interestingly, common risk factors may be postulated for both cancers. Considering the rarity of this adverse event, its short-term temporal relation with the administration of the drug, which makes a relation improbable, and the coexistence of other risk factors, which may provide plausible explanations, it is possible to conclude according to the WHO Adverse Reaction Terminology that a causal relation between the occurrence of this serious adverse event and the exposure to the drug is unlikely. However, the case deserves to be reported in the literature. |
| first_indexed | 2024-12-21T11:53:52Z |
| format | Article |
| id | doaj.art-2a963e7cb8e54322b62983d19f832991 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-21T11:53:52Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-2a963e7cb8e54322b62983d19f8329912022-12-21T19:04:59ZengBMCBMC Cancer1471-24072018-10-011811510.1186/s12885-018-4919-zA case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinomaDaniele Lavacchi0Stefania Nobili1Marco Brugia2Agnese Paderi3Sara Fancelli4Enrico Caliman5Federica Vergoni6Enrico Mini7School of Human Health Sciences, University of FlorenceDepartment of Health Sciences, University of FlorenceDepartment of Experimental and Clinical Medicine, University of FlorenceSchool of Human Health Sciences, University of FlorenceSchool of Human Health Sciences, University of FlorenceSchool of Human Health Sciences, University of FlorencePathological Anatomy Unit, Careggi University HospitalDepartment of Health Sciences, University of FlorenceAbstract Background Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy of the skin characterized by high aggressiveness. Four main factors are implicated in its development: immunosuppression, ultraviolet radiation, age and the Merkel cell polyomavirus (MCPyV). In recent years, immune checkpoint inhibitors have shown clinical activity in MCC treatment. Case presentation We report the case of an 82-year-old man with a lung adenocarcinoma diagnosis, who underwent immunotherapy with nivolumab as second-line treatment. Seven months after the diagnosis of lung cancer during the nivolumab treatment, the patient developed an eyelid MCC, initially misdiagnosed as a chalazion. A palliative radiotherapy was performed with clinical benefit. After a total of seven cycles of nivolumab, computed tomography showed a lung and cerebral disease progression. In addition, clinical conditions worsened leading to the patient’s death 13 months after the initial lung cancer diagnosis. Conclusions Cases of co-occurrence of MCC and non-small cell lung cancer (NSCLC) have rarely been reported. Interestingly, common risk factors may be postulated for both cancers. Considering the rarity of this adverse event, its short-term temporal relation with the administration of the drug, which makes a relation improbable, and the coexistence of other risk factors, which may provide plausible explanations, it is possible to conclude according to the WHO Adverse Reaction Terminology that a causal relation between the occurrence of this serious adverse event and the exposure to the drug is unlikely. However, the case deserves to be reported in the literature.http://link.springer.com/article/10.1186/s12885-018-4919-zMerkel cell carcinomaNSCLCNivolumabMCPyVEyelid MCCElderly |
| spellingShingle | Daniele Lavacchi Stefania Nobili Marco Brugia Agnese Paderi Sara Fancelli Enrico Caliman Federica Vergoni Enrico Mini A case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma BMC Cancer Merkel cell carcinoma NSCLC Nivolumab MCPyV Eyelid MCC Elderly |
| title | A case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma |
| title_full | A case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma |
| title_fullStr | A case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma |
| title_full_unstemmed | A case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma |
| title_short | A case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma |
| title_sort | case report of eyelid merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma |
| topic | Merkel cell carcinoma NSCLC Nivolumab MCPyV Eyelid MCC Elderly |
| url | http://link.springer.com/article/10.1186/s12885-018-4919-z |
| work_keys_str_mv | AT danielelavacchi acasereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT stefanianobili acasereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT marcobrugia acasereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT agnesepaderi acasereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT sarafancelli acasereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT enricocaliman acasereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT federicavergoni acasereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT enricomini acasereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT danielelavacchi casereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT stefanianobili casereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT marcobrugia casereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT agnesepaderi casereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT sarafancelli casereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT enricocaliman casereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT federicavergoni casereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma AT enricomini casereportofeyelidmerkelcellcarcinomaoccurringundertreatmentwithnivolumabforalungadenocarcinoma |