Merkel cell carcinoma: A case of palliative upper limb amputation in a patient with refractory in-transit metastases

The Australasian Journal of Dermatology
Dakshika A GunaratneMichael J Veness

Abstract

We report an unusual case of Merkel cell carcinoma in a 70-year-old woman with the rapid development of left upper limb in-transit and hepatic metastases. The patient had a preceding history of left-sided breast cancer. Palliative chemotherapy with carboplatin and etoposide produced a minimal response. The in-transit metastases rapidly progressed and were refractory to chemotherapy and a single fraction of palliative radiotherapy, leading to a marked impact on her quality of life, secondary to sepsis and bleeding. After lengthy discussion, she consented to an above-elbow amputation resulting in a marked improvement in her well-being. In this case, we believe that palliative amputation of the involved arm was justified and beneficial to the patient.

References

Aug 30, 2005·International Journal of Radiation Oncology, Biology, Physics·Michael G PoulsenLee Tripcony
Feb 25, 2010·Annals of Surgical Oncology·Stephen B Edge, Carolyn C Compton
Feb 18, 2011·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Nathalie C ZeitouniJohn M Kane
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Aug 1, 2013·The British Journal of Dermatology·G HrubyJ F Thompson
Jan 28, 2014·Current Opinion in Otolaryngology & Head and Neck Surgery·Gerhard F Huber

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Citations

Feb 6, 2017·Hand : Official Journal of the American Association for Hand Surgery·Donevan R WesterveldWinston T Richards
Apr 1, 2017·International Journal of Particle Therapy·Meghan W MacomberUpendra Parvathaneni

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