IMMUNOTHERAPY APPLIED TO NEOPLASIA OFMERKELMETASTATIC IN IMMUNOSUPPRESSED PATIENT

• DOI: 10.22533/at.ed.15932423310310

• Palavras-chave: oncology; skin tumors; Merkel neoplasm; immunotherapy; immunosuppression

• Keywords: oncology; skin tumors; Merkel neoplasm; immunotherapy; immunosuppression

• Abstract:

  Male patient, 59 years old, with a history of kidney transplantation for amyloidosis in October/2015 and, therefore, immunosuppressed. The patient evolved with a progressively growing nodule on the dorsum of the right hand and a nodule on the right malar region, and underwent resection with a pathology compatible with Merckel cell carcinoma — positive immunohistochemistry for chromogranin and synaptophysin — in the malar region and squamous cell carcinoma in the dorsal region of the right hand. After a few months, a new nodule appeared in the malar region with new resection and selective neck dissection with pathological examination compatible with metastasis of merkel cell carcinoma in 4/4 lymph nodes found. At that time, PET-CT was requested, which showed the presence of a 2.2 cm nodule in the left infraorbital dermis (SUV 9.3) and adjuvant radiotherapy was started in the malar region. After a short period of time, there was a new important local tumor progression during radiotherapy. Initiated Avelumab with satisfactory response, including complete response on evaluation and good tolerance to immunotherapy.