Abstract
A 65-year-old man noticed a nodule on his big toe 3 months previously. He was referred to our hospital because of rapid enlargement. A 25-mm dusky red tumor was observed on his right big toe. Histological findings from a skin biopsy revealed proliferation of relatively small CK20-positive atypical cells from the superficial dermis to the subcutaneous tissue. Therefore, this tumor was diagnosed as Merkel cell carcinoma. Amputation of the right big toe was performed. We performed right inguinal lymph node resection, and the lymph nodes were negative for disease. Additional radiation therapy at the original site was administered after the operation. Two years after the first operation, local recurrence occurred at the right external condyle, without any distant metastasis. Merkel cell polyomavirus was detected on polymerase chain reaction. The face is a well-recognized site considering the predilection for Merkel cell carcinoma. The present case is considered very rare because the original site was the big toe.[Skin Cancer (Japan) 2016 ; 31 : 30-34]
