Case Report: Simultaneous Merkel Cell Carcinoma and Colorectal Cancer
Posted: Tuesday, April 27, 2021
For patients with Merkel cell carcinoma who are also diagnosed with other malignancies, checkpoint immunotherapy is the standard of care. Still, different strategies such as combining immune checkpoint inhibitors with other agents may be of use based on the prognosis of both tumors, according to findings of a case study presented in Cureus. Conventional chemotherapy, other immunotherapy, or targeted therapy are other options, noted Parham Khosravi-Shahi, MD, PhD, of the Hospital General Universitario Gregorio Marañon, Spain.
“Synchronous tumors should be treated depending on prognosis,” the authors noted. “The first tumor to treat is the one with a poorer prognosis or life-threatening ones.”
The case features a 73-year-old man who was admitted to the hospital with acute intestinal obstruction. Following a CT scan, a colonoscopy revealed an occlusion lesion. The lesion was biopsied and was found to be an adenocarcinoma. During the patient’s stay, he also reported a painless, purple, shiny bump on his left leg. A biopsy of the bump confirmed Merkel cell carcinoma.
Doctors decided to avoid skin cancer surgery and began palliative chemotherapy for metastatic colorectal cancer. He received fluorouracil (5-FU) and a continuous infusion of 5-FU, leucovorin, and irinotecan (FOLFIRI) for 46 hours.
After six cycles, scans showed a partial response in the colon, liver, and retroperitoneal lesions. The authors noted a “remarkable” change in the Merkel cell carcinoma, significantly reduced in size.
“We need to point out the great and long-time response observed in our patient,” the authors added. “It is hard to say if it is related to the FOLFIRI regimen, to the anti-EGFR treatment, or to both of them.”
Disclosure: The authors reported no conflicts of interest.