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Int J Clin Exp Pathol 2012;5(9):1007-1012

Case Report
Metastatic merkel cell carcinoma in the bone marrow of a patient with plasma cell
myeloma and therapy-related myelodysplastic syndrome

Megan Kielt Kressin, Annette S Kim

Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pathology &
Laboratory Medicine, Tennessee Valley Healthcare System Veterans Affairs, Nashville, TN, USA; Current address: Austin Pathology Associates,
901 W. Ben White Blvd., Austin, TX, USA.

Received August 30, 2012; Accepted September 21, 2012; Epub October 20, 2012; Published October 30, 2012

Abstract: Merkel cell carcinoma is an aggressive neoplasm of the skin that shows frequent lymph node metastases, but has only rarely been
reported in the bone marrow. Herein we report a case of a 64-year-old male with a history of plasma cell myeloma and recent skin diagnosis of
Merkel cell carcinoma who presented for a routine follow-up bone marrow to assess his myeloma. The biopsy showed persistent plasma cell
myeloma, trilineage dysplasia, and clusters of neuroendocrine cells consistent with metastatic Merkel cell carcinoma. Discussion of this case,
a review of metastatic Merkel cell carcinoma, and identification of clinical settings in which staging bone marrow biopsy may be warranted are
presented. (IJCEP1208027).

Keywords: Merkel cell, bone marrow metastases, plasma cell myeloma

Address all correspondence to:
Dr. Annette S Kim
Department of Pathology, Microbiology and
Immunology, Vanderbilt University Medical Center
1301 Medical Center Dr, 4603A TVC
Nashville, TN 37232-5310, USA.
Phone: 615-343-7745; Fax: 615-343-7961
E-mail: annette.s.kim@Vanderbilt.Edu