Seizure Risk and Merkel Cell Carcinoma Metastasis: Case Report
Posted: Thursday, January 7, 2021
For patients with Merkel cell carcinoma, seizures due to bone metastases compressing the brain are rare, but not uncommon, according to a patient profile featured in Case Reports in Medicine. “Therefore, previous oncological diagnoses and imaging are of key importance in clarifying the origins of solitary bone lesions of the skull,” explained Gergely Toldi, MD, PhD, of Semmelweis University, Budapest, Hungary, and colleagues.
The patient was a 62-year-old female who presented with a grand mal epileptic seizure. Her medical history was significant for chronic lymphoid leukemia. Two years prior, the patient had an atheroma removed from the right upper arm, which was revealed as Merkel cell carcinoma. Chemotherapy was initiated but terminated due to excessive bone marrow suppression. Furthermore, the analysis showed carcinoma metastasis to the axillary lymph nodes due to her cancers.
Physical examination was unremarkable with no abnormalities. However, an MRI scan revealed an epidural bone mass (2 cm x 2.8 cm x 5 cm) in the right parietal region, with high intensity on T2 and fluid-attenuated inversion recovery imaging modalities. In addition, bone metastases were identified in the right parietal region and bilateral frontal regions. Moreover, electroencephalographic monitoring showed decreased functioning in the right cerebral hemisphere. Additional flow-cytometry analysis of the cerebrospinal fluid did not reveal Merkel cell carcinoma metastasis, which resulted in the decision to utilize carbamazepine as a therapeutic intervention. Although no additional seizures arose, the patient ultimately died as a result of Merkel cell carcinoma metastasis.
“Patient history, clinical presentation, and radiological findings enabled a suspected diagnosis of skull metastasis of Merkel cell carcinoma compressing the brain, causing symptomatic seizures,” the authors explained.
Disclosure: For full disclosures of the study authors, visit hindawi.com.
