We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Correspondence |

Distinction of 2 Different Primary Merkel Cell Carcinomas in 1 Patient by Merkel Cell Polyomavirus Genome Analysis

David Schrama, PhD; Anja Thiemann, MD; Roland Houben, PhD; Katharina C. Kähler, MD; Jürgen C. Becker, MD, PhD; Axel Hauschild, MD
Arch Dermatol. 2010;146(6):687-689. doi:10.1001/archdermatol.2010.121.
Text Size: A A A
Published online


Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin carcinoma.1 Owing to the recent isolation of a new human polyomavirus from MCC called Merkel cell polyomavirus (MCV),2 this malignancy has attracted much attention. Meanwhile, several groups have confirmed that MCV is detectable in 70% to 80% of MCC. Herein, we report how sequencing of the MCV genome may help to discern between delayed metastasis and multiple primary MCCs.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

Large T antigen (LTA) in our patient's Merkel cell carcinoma (MCC) samples taken in 2002 (MCC-1) and 2008 (MCC-2). A, Merkel cell polyomavirus (MCV) DNA obtained from MCC-1 and MCC-2 were quantified as normalized reporter (Rn) for long interspersed nuclear elements (LINE) (brown) serving as endogenous controls, MCV-specific regions of LTA (LT3) (green), and viral protein 1 (VP1) (blue). (The value of Rn is automatically calculated by the real-time polymerase chain reaction analyzer as the fluorescence emission intensity of the reporter dye divided by the fluorescence emission intensity of the passive reference dye.) The black horizontal dotted line serves as the threshold line. B and C, Immunohistologic detection of LTA expression in MCC-1 (B) and MCC-2 (C). Sections of the respective lesions were stained with a monoclonal antibody (clone CM2B4 at 1:1000 dilution) specific for MCV LTA (red) and counterstained with hematoxylin-eosin (blue). D, Partial sequence alignment of LTA from MCC-1 and MCC-2. On the left side, the alignment demonstrates 2 base mismatches between MCC-1 and MCC-2 and the base deletion for MCC-1. On the right side, the original sequence data contain a mismatch, and the deletion is shown.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

5 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles