{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T20:47:44Z","timestamp":1762980464959,"version":"3.44.0"},"reference-count":30,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,9,8]]},"abstract":"<jats:p>We describe an unusual presentation of Merkel cell carcinoma (MCC), a rare neuroendocrine cutaneous tumour. A 59-year-old man presented with a 2-week history of dyspnoea on a background of MCC of the left elbow that was diagnosed after an axillary lymph node metastasis had appeared. He was clinically diagnosed with cardiac tamponade and received urgent pericardiocentesis. Thoracic CT imaging revealed a large infiltrating mass within the inferior aspect of the heart, confirmed to be MCC via immunohistochemistry of the pericardial fluid. On review of prior fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging, avid uptake was evident at the corresponding site of disease. This case has several important illustrative aspects, including the clinical manifestations of cardiac metastases, the challenges of MCC histopathological diagnosis and the role of imaging (in particular FDG-PET) in this aggressive disease.<\/jats:p>","DOI":"10.1136\/bcr-2017-221311","type":"journal-article","created":{"date-parts":[[2017,9,26]],"date-time":"2017-09-26T03:05:16Z","timestamp":1506395116000},"page":"bcr-2017-221311","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Merkel cell carcinoma cardiac metastasis causing cardiac tamponade"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2190-8993","authenticated-orcid":false,"given":"Murray","family":"Di Loreto","sequence":"first","affiliation":[{"name":"Nuclear Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roslyn","family":"Francis","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,9,25]]},"reference":[{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1972.01620040075020"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.2","doi-asserted-by":"publisher","DOI":"10.1038\/nature13250"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.3","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20167"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.smj.0000197039.06853.f0"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.5","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1177\/000313481508100819","article-title":"Dramatic increase in the incidence and mortality from Merkel cell carcinoma in the United States","volume":"81","author":"Fitzgerald","year":"2015","journal-title":"Am Surg"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.6","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/j.1365-2133.2011.10493.x","article-title":"Merkel cell carcinoma in Western Australia: a population-based study of incidence and survival","volume":"165","author":"Girschik","year":"2011","journal-title":"Br J Dermatol"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.7","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2014.124"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2009.01370.x"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.9","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s40257-015-0163-3","article-title":"Merkel cell carcinoma: current issues regarding diagnosis, management, and emerging treatment strategies","volume":"17","author":"Brummer","year":"2016","journal-title":"Am J Clin Dermatol"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.10","doi-asserted-by":"publisher","DOI":"10.1172\/JCI64116"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.11","doi-asserted-by":"publisher","DOI":"10.1126\/science.1152586"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.12","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-001-0204-4"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.13","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19990615)85:12<2589::AID-CNCR15>3.0.CO;2-F"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.14","first-page":"195","article-title":"Neoplasms metastatic to the heart: review of 3314 consecutive autopsies","volume":"3","author":"Abraham","year":"1990","journal-title":"Am J Cardiovasc Pathol"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.15","doi-asserted-by":"publisher","DOI":"10.2165\/00129784-200303060-00004"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2013\/850797","article-title":"A practical update of surgical management of Merkel cell carcinoma of the skin","volume":"2013","author":"Tai","year":"2013","journal-title":"ISRN Surg"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.17","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.ejca.2016.10.022","article-title":"Merkel cell carcinoma: epidemiology, prognosis, therapy and unmet medical needs","volume":"71","author":"Schadendorf","year":"2017","journal-title":"Eur J Cancer"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.18","doi-asserted-by":"publisher","DOI":"10.1007\/s11864-013-0225-9"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.48.3073"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.20","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1007\/s10147-004-0396-2","article-title":"Cardiac metastasis from Merkel cell skin carcinoma","volume":"9","author":"Yamana","year":"2004","journal-title":"Int J Clin Oncol"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.21","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000790"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.22","first-page":"675","article-title":"A 30-year analysis of cardiac neoplasms at autopsy","volume":"21","author":"Butany","year":"2005","journal-title":"Can J Cardiol"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.23","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/MNM.0000000000000039","article-title":"The impact of (18)F-FDG-PET\/CT on Merkel cell carcinoma management: a retrospective study of 66 scans from a single institution","volume":"35","author":"George","year":"2014","journal-title":"Nucl Med Commun"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.24","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-013-0040-x"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.03994.x"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.26","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/ajd.12400","article-title":"Lack of clinical impact of (18) F-fluorodeoxyglucose positron emission tomography with simultaneous computed tomography for stage I and II Merkel cell carcinoma with concurrent sentinel lymph node biopsy staging: A single institutional experience from Westmead Hospital, Sydney","volume":"58","author":"Liu","year":"2017","journal-title":"Australas J Dermatol"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.27","first-page":"321","article-title":"Use of PET\/CT scanning in cancer patients: technical and practical considerations","volume":"18","author":"Griffeth","year":"2005","journal-title":"Proc"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.28","doi-asserted-by":"crossref","first-page":"e59","DOI":"10.2349\/biij.2.4.e59","article-title":"Physiological uptake in FDG PET simulating disease","volume":"2","author":"Ahmad Sarji","year":"2006","journal-title":"Biomed Imaging Interv J"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.29","doi-asserted-by":"publisher","DOI":"10.1148\/rg.315115003"},{"key":"2025082804405516000_2017.sep25_1.bcr-2017-221311.30","doi-asserted-by":"publisher","DOI":"10.1007\/s12350-011-9358-z"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-221311","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:41:06Z","timestamp":1756381266000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-221311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,25]]},"references-count":30,"alternative-id":["10.1136\/bcr-2017-221311"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-221311","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,9,25]]}}}