Background Merkel cell carcinoma (MCC) is a kind of cutaneous neuroendocrine malignancy with a poor prognosis. combining endostar and apatinib was administered and a partial response achieved after 2.0 months of treatment, and 6.5 months of progression-free survival was achieved. Overall survival was 13.0 months. Conclusion We believe Rabbit polyclonal to COPE that antiangiogenic therapy is an extremely effective treatment for MCC, especially for patients who cannot tolerate chemotherapy and radiotherapy. strong class=”kwd-title” Keywords: Merkel cell carcinoma, antiangiogenic therapy, endostar, apatinib Background Merkel cell carcinoma (MCC) is usually a kind of cutaneous neuroendocrine malignancy with a poor prognosis. It is characterized by a high rate of recurrence and metastases, including distant metastases and regional nodal metastases. There has been controversy about the origins of MCC business, and different scholars have different views.1,2 Clinically, MCC often manifests as obvious single painless BMS-354825 kinase activity assay hard nodules visible in sun irradiation of diameter 2 cm and also not uncommonly 2 cm, with quick growth and metastases, especially lymph node metastases.3 Clinically, MCC is easily confused with other cancers of the skin, such as metastasis of squamous cell carcinoma, melanoma, and other tumors. The positive expression of certain antibodies in immunohistochemical staining is an important diagnostic tool to distinguish MCC from these tumors. At present, the combination of postoperative radiotherapy and chemotherapy is usually often used, but there is no standard protocol for chemotherapy. Angiogenesis is an important process in tumor development. Inhibiting vascular regeneration can prolong survival and delay progression of disease. In this paper, we statement a case of MCC treated with antiangiogenic therapy in our department combined with a literature review, in order to provide a reference for the clinical diagnosis and treatment of MCC. Case presentation This case issues an 86-year-old man who used to be a soldier. He found a mass on the right thigh with a 2.52.01.2 cm red nodule at the beginning of May 2017. Surgical resection was performed at the local Peoples Hospital. The results of pathological examination after surgery in local hospital showed a right thigh BMS-354825 kinase activity assay subcutaneous small cell malignant tumor of about 2.52.01.2 cm (Physique 1). The pathology immunohistochemistry in our hospital indicated CK-L+, Syn++, CgA+, CD56++, Ki67+, CK-H?, CK7?, CK20+, TTF-1?, CD20?, CD3?, and S100?, implying MCC. According to the pathology and immunohistochemistry, he was diagnosed with MCC T2N1M0. Open in a separate windows Physique 1 The pathology and immunohistochemistry of the patient. Notes: (A) H&E staining with surgical specimens. (B) Immunohistochemistry: dot-like positivity for CK20. (C) Immunohistochemistry: negativity for CK7. (A) 200; (B, C) 400. In mid-July 2017, multiple reddish masses appeared in the surgical incision area, of which the largest was hard and about 1.5 cm in diameter (Determine 2A). A metastatic lymph node was found in the right inguinal region on computed tomography (CT), ~2.2 cm in diameter without distant metastasis (Determine 3A). Next-generation sequencing from his peripheral blood showed em KDM5A /em G931D mutation, which may have been associated with oncogenesis. Open in a separate window Physique 2 Changes in lesions during treatment of the patient. Notes: (A) After surgery, before treatment; (B) after the first treatment; (C) after the second treatment; (D) after the third treatment; (E) after the fourth treatment; (F) after the fifth treatment; (G) after the sixth treatment; (H) after the seventh treatment; (I) after the eighth treatment. From your pictures, masses reduced significantly during two cycles (ACC). From the third cycle (D), tumors had a recurrent pattern. After three cycles (DCF), tumors experienced started disappearing. From your sixth to eighth cycles (GCI), the masses were BMS-354825 kinase activity assay increasing gradually. Open in a separate window Physique 3 Changes on CT scans during treatment. Note: (A) Metastatic lymph node (2.2 cm) on July 31, 2017; (B) metastatic lymph node (2.2 cm) on October 23, 2017; (C) metastatic lymph node (1.3 BMS-354825 kinase activity assay cm) on December 26, 2017; (D) metastatic lymph node (1.3 cm) on March 5, 2018. Abbreviation: CT, computed tomography. Due to his old age, the patient and his.