CC BY 4.0 · Brazilian Journal of Oncology 2023; 19: e-20230404
DOI: 10.5935/2526-8732.20230404
Case Report
Clinical Oncology

Total remission of Merkel cell carcinoma after Coronavirus infection: a case report

Remissão total do carcinoma de células de Merkel após infecção por Coronavírus: relato de caso
Lucas Henrique Rigon Vidoto
1   Instituto Nacional do Câncer - INCA, Oncologia Clínica, Rio de Janeiro - RJ, Brazil
,
Cicero Luiz Cunha Martins
1   Instituto Nacional do Câncer - INCA, Oncologia Clínica, Rio de Janeiro - RJ, Brazil
,
Andreia Cristina De Melo
1   Instituto Nacional do Câncer - INCA, Oncologia Clínica, Rio de Janeiro - RJ, Brazil
› Author Affiliations
Financial support: No.

ABSTRACT

A 65-years old Peruvian woman was admitted to the Brazilian National Cancer Institute, with a diagnosis of Merkel cell carcinoma in the left shoulder. A PET-CT confirmed the locally advanced disease, with the involvement of lymph nodes in the axillary region. At the time of the proposed surgical procedure, the patient tested positive for COVID-19 without symptoms. She returned for an appointment one month later recovering from COVID-19, reporting a significant decrease in the lesion. One month later, no lesion was clinically found on the left shoulder. Due to the possible remission of the disease, a new PET CT was requested, revealing no metabolic findings suggestive of active neoplastic tissue.

RESUMO

Uma mulher peruana de 65 anos foi admitida no Instituto Nacional do Câncer com diagnóstico de carcinoma de células de Merkel no ombro esquerdo. A PET-CT confirmou a doença localmente avançada, com envolvimento de gánglios linfáticos da região axilar. No momento do procedimento cirúrgico proposto, a paciente testou positivo para COVID-19 sem sintomas. Retornou à consulta um mês depois, recuperando-se da COVID-19, relatando diminuição significativa da lesão. Um mês depois, nenhuma lesão foi encontrada clinicamente no ombro esquerdo. Devido à possível remissão da doença, foi solicitada nova PET-CT, não revelando achados metabólicos sugestivos de tecido neoplásico ativo.



Publication History

Received: 16 January 2023

Accepted: 10 March 2023

Article published online:
26 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

Bibliographical Record
Lucas Henrique Rigon Vidoto, Cicero Luiz Cunha Martins, Andreia Cristina De Melo. Total remission of Merkel cell carcinoma after Coronavirus infection: a case report. Brazilian Journal of Oncology 2023; 19: e-20230404.
DOI: 10.5935/2526-8732.20230404
 
  • REFERENCES

  • 1 Tothill R, Estall V, Rischin D. Merkel cell carcinoma: emerging biology, current approaches, and future directions. Am Soc Clin Oncol Educ Book 2015: e519-e26
  • 2 Ratner D, Nelson BR, Brown MD, Johnson TM. Merkel cell carcinoma. J Am Acad Dermatol 1993; 29 2 Pt 1 143-6
  • 3 Tilling T, Moll I. Which are the cells of origin in Merkel cell carcinoma?. J Skin Cancer 2012; 2012: 680410
  • 4 Stang A, Becker JC, Nghiem P, Ferlay J. The association between geographic location and incidence of Merkel cell carcinoma in comparison to melanoma: an international assessment. Eur J Cancer 2018; 94: 47-60
  • 5 Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE. Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study. J Cutan Pathol 2010; Jan 37 (01) 20-7
  • 6 Howard RA, Dores GM, Curtis RE, Anderson WF, Travis LB. Merkel cell carcinoma and multiple primary cancers. Cancer Epidemiol Biomarkers Prev 2006; Aug 15 (08) 1545-9
  • 7 Engels EA, Frisch M, Goedert JJ, Biggar RJ, Miller RW. Merkel cell carcinoma and HIV infection. Lancet 2002; Feb 359 (9305) 497-8
  • 8 Paulson KG, Park SY, Vandeven NA, Lachance K, Thomas H, Chapuis AG. et al. Merkel cell carcinoma: current US incidence and projected increases based on changing demographics. J Am Acad Dermatol 2018; Mar 78 (03) 457-63.e2
  • 9 Melo AC, Thuler LCS. Trends in the incidence and morbidity of Merkel cell carcinoma in Brazil. Future Oncol 2021; Aug 17 (22) 2857-65
  • 10 Leroux-Kozal V, Lévêque N, Brodard V, Lesage C, Dudez O, Makeieff M. et al. Merkel cell carcinoma: histopathologic and prognostic features according to the immunohistochemical expression of Merkel cell polyomavirus large T antigen correlated with viral load. Hum Pathol 2015; Mar 46 (03) 443-53
  • 11 Moghaddam PA, Cornejo KM, Hutchinson L, Tomaszewicz K, Dresser K, Deng A. et al. Complete spontaneous regression of merkel cell carcinoma after biopsy: a case report and review of the literature. Am J Dermatopathol 2016; Nov 38 (11) e154-e8
  • 12 Terui H, Fujimura T, Kakizaki A, Furudate S, Aiba S. Merkel cell carcinoma with spontaneous regression: a case report and immunohistochemical study. Case Rep Dermatol 2016; Feb 8: 52-8
  • 13 Kaufman HL, Russell J, Hamid O, Bhatia S, Terheyden P, D’Angelo SP. et al. Avelumab in patients with chemotherapy-refractory metastatic Merkel cell carcinoma: a multicentre, single-group, open-label, phase 2 trial. Lancet Oncol 2016; Oct 17 (10) 1374-85
  • 14 Kaufman HL, Russell JS, Hamid O, Bhatia S, Terheyden P, D’Angelo SP. et al. Updated efficacy of avelumab in patients with previously treated metastatic Merkel cell carcinoma after ≥1 year of follow-up: JAVELIN Merkel 200, a phase 2 clinical trial. J Immunother Cancer 2018; Jan 6 (01) 7
  • 15 Nghiem P, Bhatia S, Brohl AS, Hamid O, Mehnert JM, Terheyden P. et al. Two-year efficacy and safety update from JAVELIN Merkel 200 part A: a registrational study of avelumab in metastatic Merkel cell carcinoma progressed on chemotherapy. J Clin Oncol 2018; 36 Suppl 1 ASCO#9507
  • 16 Nghiem P, Bhatia S, Lipson EJ, Sharfman WH, Kudchadkar RR, Brohl AS. et al. Durable tumor regression and overall survival in patients with advanced Merkel cell carcinoma receiving pembrolizumab as first-line therapy. J Clin Oncol 2019; 37 (09) 693-702
  • 17 Nghiem PT, Bhatia S, Lipson EJ, Kudchadkar RR, Miller NJ, Annamalai L. et al. PD-1 blockade with pembrolizumab in advanced Merkel-cell carcinoma. N Engl J Med 2016; Jun 374 (26) 2542-52
  • 18 Topalian SL, Bhatia S, Hollebecque A, Awada A, Boer JP, Kudchadkar RR. et al. Non-comparative, open-label, multiple cohort, phase 1/2 study to evaluate nivolumab (NIVO) in patients with virus-associated tumors (CheckMate 358): efficacy and safety in Merkel cell carcinoma (MCC). Cancer Res 2017; Jul 77 Suppl 13 CT074
  • 19 Abe R, Ogawa K, Maruyama Y, Nakamura N, Abe M. Spontaneous regression of diffuse large B-cell lymphoma harbouring Epstein-Barr virus: a case report and review of the literature. J Clin Exp Hematop 2007; Apr 47 (01) 23-6
  • 20 Buckner TW, Dunphy C, Fedoriw YD, Van Deventer H, Foster MC, Richards KL. et al. Complete spontaneous remission of diffuse large B-cell lymphoma of the maxillary sinus after concurrent infections. Clin Lymphoma Myeloma Leuk 2012; Dec 12 (06) 455-8
  • 21 Yilmaz F, Yasar S, Tuncali MC, Akin S. Complete response in a frail patient with high-grade B-cell lymphoma to only one cycle of R-CHOP or to prolonged COVID-19?. Semin Oncol 2021; Aug/Dec 48 4-6 279-282
  • 22 Zhang B, Bowerman NA, Salama JK, Schmidt H, Spiotto MT, Schietinger A. et al. Induced sensitization of tumor stroma leads to eradication of established cancer by T cells. J Exp Med 2007; Jan 204 (01) e49-e55
  • 23 Bucktrout SL, Bluestone JA, Ramsdell F. Recent advances in immunotherapies: from infection and autoimmunity, to cancer, and back again. Genome Med 2018; Oct 10 (01) 79
  • 24 Oliveira DS, Medeiros NI, Gomes JAS. Immune response in COVID-19: what do we currently know?. Microb Pathog 2020; Nov 148: 104484
  • 25 García LF. Immune response, inflammation, and the clinical spectrum of COVID-19. Front Immunol 2020; 11: 1441
  • 26 Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19). JAMA 2020; 324 (08) 782-93
  • 27 Li W, Moore MJ, Vasilieva N, Sui J, Wong SK, Berne MA. et al. Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature 2003; Nov 426: 450-4
  • 28 Chen Y, Guo Y, Pan Y, Zhao ZJ. Structure analysis of the receptor binding of 2019-nCoV. Biochem Biophys Res Commun 2020; Feb 525 (01) 135-40
  • 29 Letko M, Marzi A, Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B beta coronaviruses. Nat Microbiol 2020; Apr 5 (04) 562-9
  • 30 Xue X, Mi Z, Wang Z, Pang Z, Liu H, Zhang F. High expression of ACE2 on keratinocytes reveals skin as a potential target for SARS-CoV-2. J Invest Dermatol 2021; 141 (01) 206-209.e1