Volume 3, Issue 2, Pages (March 2017)

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Volume 3, Issue 2, Pages 131-134 (March 2017) Multiple Merkel cell carcinomas: Late metastasis or multiple primary tumors? A molecular study Madhulika Eluri, BS, Ashley Feneran, DO, Jeremy S. Bordeaux, MD, MPH, Beth Ruben, MD, Stephen Ostrowski, MD, Boris C. Bastian, MD, Kord Honda, MD JAAD Case Reports Volume 3, Issue 2, Pages 131-134 (March 2017) DOI: 10.1016/j.jdcr.2017.01.011 Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A, Wide local excision of the right side of the nose from 2012 found thin islands and cords and small nests of atypical cells with finely distributed basophilic nuclei without prominent nucleoli and mild pink cytoplasm. Mitotic figures and occasional necrotic cells are identified. Biopsy of the nose from 2004 (B) and the left arm (C) stained positive with CK20. JAAD Case Reports 2017 3, 131-134DOI: (10.1016/j.jdcr.2017.01.011) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 aCGH results from 2004 left arm shows multiple gains and losses. JAAD Case Reports 2017 3, 131-134DOI: (10.1016/j.jdcr.2017.01.011) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 aCGH results from 2012 specimen from the right side of the nose show multiple gains and losses. There was not significant overlap between the 2004 and 2012 data, suggesting they are separate primary lesions. JAAD Case Reports 2017 3, 131-134DOI: (10.1016/j.jdcr.2017.01.011) Copyright © 2017 American Academy of Dermatology, Inc. Terms and Conditions