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DOI: 10.1055/a-2089-4770
ZNS- und Nebennierenmetastasen bei Merkelzellkarzinom – ein besonderer Fall
Metastases of the Brain and the Adrenal Glands – A Rare Case of Merkel Cell Carcinoma
Zusammenfassung
Das Merkelzellkarzinom ist ein hochaggressiver, seltener Hauttumor. Bei Erstdiagnose bestehen bereits bei 30% der Patienten loko-regionäre Lymphknotenmetastasen. Fernmetastasen finden sich häufig in entfernten Lymphknotenstationen, der Haut, den abdominellen Organen und den Knochen. Bei Auftreten von Fernmetastasen reduziert sich das 5-Jahres-Überleben auf 18%. Wir berichten über eine Patientin mit Merkelzellkarzinom, die ein Jahr nach Erstdiagnose Fernmetastasen im ZNS und den Nebennieren entwickelte. Beide Lokalisationen sind bisher selten beschrieben. Therapeutisch kamen Radiatio, Radiochirurgie und eine Immuntherapie mit Avelumab zum Einsatz. Während sich hierunter eine komplette Remission der Hirnfiliae zeigte, führte ein rasanter Progress der Nebennierenmetastasen zur Umstellung auf eine palliative platinbasierte Chemotherapie.
Abstract
Merkel cell carcinoma is a highly aggressive but rare malignancy of the skin. At the time of initial diagnosis, 30% of the patients already have loco-regional lymph node metastases. Distant metastases are commonly found in other lymph nodes stations, the skin, abdominal organs and bones. In distant metastases the 5-year overall survival (OS) is reduced to 18%. We report on a patient with Merkel cell carcinoma who developed distant metastases of the brain and the adrenal glands one year after initial diagnosis. Both are rare locations. Radiotherapy, radiosurgery and immunotherapy with Avelumab were applied, showing good response especially for the brain metastases. However fast progression of the metastases in the adrenal glands finally led to readjustment to a palliative platin-based chemotherapy.
Publication History
Article published online:
31 July 2023
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