18F-FDG and 18F-AIF-NOTA-Octreotide PET/CT Confirmed a Rare Case of Cutaneous Merkel Cell Carcinoma With a Solitary Local Nodal Metastasis

Cutaneous Merkel cell carcinoma with local nodal metastasis is a rare entity. A 56-year-old man presented with a nontender left inguinal mass, and ultrasound-guided biopsy of this nodal mass confirmed nodal metastasis with strong neuroendocrine differentiation from cutaneous Merkel cell carcinoma. Staging 18F-FDG PET/CT showed a solitary 3.9 × 6.8-cm hypermetabolic left groin mass with no other suspicious lesions elsewhere. To confirm the patient's eligibility for radical curative treatment, taking into consideration of its neuroendocrine differentiation, a subsequent 18F-AIF-NOTA-octreotide PET/CT was performed, which demonstrated only solitary somatostatin receptor-positive left inguinal mass. The patient underwent radical treatment.

 

Comments:

It sounds like the patient's case was quite complex, especially with the rarity of cutaneous Merkel cell carcinoma and its neuroendocrine differentiation. The use of imaging techniques like PET/CT scans, particularly the specialized 18F-AIF-NOTA-octreotide PET/CT, was crucial in confirming the presence of somatostatin receptor-positive lesions, aiding in treatment planning.

Radical treatment likely involved aggressive measures to address the primary tumor in the left inguinal area and any potential metastases. This might have included surgery, radiation therapy, and possibly systemic treatments like chemotherapy or immunotherapy.

The utilization of specialized imaging to identify specific receptors or characteristics of the tumor (like somatostatin receptor positivity) is an intriguing and promising approach, as it allows for more targeted and personalized treatment strategies.

Overall, it's encouraging that the patient underwent treatment after a thorough assessment and imaging evaluation, which could potentially improve the prognosis and outcomes for someone with such a rare and complex presentation of Merkel cell carcinoma.

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