Diagnosis of merkel cell carcinoma at chronic venous ulcer: case report

Abstract

Author(s): Qusay Jummaa Lazim, Enas Khudhair Al-Bdaer, Hanan Hussein Mohammed, Dheyauldeen Shabeeb Almirtah, Ahmed Salih Alshewere

Merkel-Cell Carcinoma (MCC) is rare and highly aggressive skin cancer, usually due to Merckel-cell polyomavirus. Venous ulcers are full-thickness defects of skin in the lower limb when these ulcers persist for more than 6 weeks; they are referred to as chronic venous ulcers. An 83-year-old male presented to Al-Sadder Teaching hospital, with a chief complaint of painful swelling of the right leg with the same side foot ulcer for one month. On examination the ulcer found in the medial aspect of the ankle, just posterior and down to the medial malleolus. Its size about 2 cm × 3 cm, with an oval shape. The edge raised and everted with whitish discoloration. The base was firm, immobile, tender, red spots floor, and whitish offensive discharge. The patient was admitted to the hospital for the correction of anemia and rehydration. Unfortunately, the patient died before chemotherapy after 6 days of final diagnosis and staging. Taking into account the frequency of cutaneous malignancies associated with Chronic Leg Ulcers (CLU); CLU presumed to be of vascular origin should be biopsied after 6 weeks to 3 months of nonhealing wounds. In the present study, we report a rare case of MCC in CLU in Misan Province, Iraq.

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