PMC8236778_01
Computed Tomography of abdomen with contrast, initial. (A) Peripancreatic lymph node, measuring 2.6 cm x 2.0 cm. (B) Ill-defined area of low attenuation in the pancreatic uncinate process measuring 2.3 cm x 1.9 cm.
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Computed tomography (CT) scan of the abdomen revealed areas of hypoattenuation in the pancreas with enlarged peripancreatic lymph nodes (Figure 1).
Endoscopic ultrasound-fine needle aspiration of head of pancreas. Malignant cells (A and B) in a necrotic background. Tumor cells show staining for synaptophysin (C) and CK-20 (D), consistent with patient's history of Merkel cell carcinoma.
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EUS-guided fine needle aspiration (FNA) showed malignant cells morphologically and immunohistochemically similar to his initial primary cancer, consistent with MCC (Figure 2).
Computed tomography abdomen with contrast, 3 months post-chemotherapy. Resolution of previously noted masses and lymphadenopathy.
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He underwent 6 cycles of chemotherapy with cisplatin/etoposide with complete resolution of the pancreatic masses and lymphadenopathy (Figure 3).