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By immunohistochemistry, KRT20 and MCPyV positivity are found in about 90% and 80% of MCCs, respectively. Noteworthy, viral status in lip\/oral cavity MCCs is poorly known. A 78-year-old male was referred presenting a tumor mass on the right maxilla four months ago. Computed tomography revealed an extensive osteolytic lesion in the right maxillary sinus extending into the orbit and nasal cavity and crossing the midline. Microscopy revealed large necrotic areas admixed by sheets of small, round cells with hyperchromatic nuclei exhibiting a '\u201csalt and pepper\u201d chromatin pattern, which showed immunopositivity for pan-KRT AE1\/AE3, EMA, CD56, CD99 (weak), CD138, S100 (focal), vimentin (focal), synaptophysin, FLI1, INSM1, MCPyV, SATB2, and Ki-67 (MKI67 [40%]). Moreover, intact RB1 and wild-type p53 expression were observed. Relevantly, KRT20, KRT5\/6, chromogranin A, p40, p63, HMB45, NF, TTF1, TDT (DNTT), PAX5, p16, KIT, as well as high-risk HPV and EBER1\/2 (both by ISH), were negative. This report illustrates that a detailed immunohistochemical study, including STAB2 and MCPyV markers, as well as a careful clinical workup, are essential to adequately classify high-grade neuroendocrine carcinomas, especially KRT20-negative MCC.<\/jats:p>","DOI":"10.1177\/10668969241308228","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T10:34:51Z","timestamp":1737110091000},"page":"1293-1298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["KRT20-\/SATB2+\/MCPyV+ Sinonasal Merkel Cell Carcinoma: A Detailed Immunohistochemical and In Situ Hybridization Study"],"prefix":"10.1177","volume":"33","author":[{"given":"Gabriela Fonseca","family":"Rocha","sequence":"first","affiliation":[{"name":"Federal University of the Jequitinhonha and Mucuri Valleys"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6724-3504","authenticated-orcid":false,"given":"Heitor Albergoni","family":"Silveira","sequence":"additional","affiliation":[{"name":"Oral Medicine, Centro Universit\u00e1rio Est\u00e1cio Ribeir\u00e3o Preto, Ribeir\u00e3o Preto, SP, Brazil"},{"name":"University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herberth Campos","family":"Silva","sequence":"additional","affiliation":[{"name":"Federal University of the Jequitinhonha and Mucuri Valleys"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Chahud","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari\u00e2ngela Ottoboni","family":"Brunaldi","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Terezinha","family":"Marques Mesquita","sequence":"additional","affiliation":[{"name":"Federal University of the Jequitinhonha and Mucuri Valleys"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Esquiche","family":"Le\u00f3n","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo"},{"name":"Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeir\u00e3o Preto Dental School (FORP\/USP), University of S\u00e3o Paulo, Ribeir\u00e3o Preto, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-017-0859-1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13143506"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-020-01219-y"},{"key":"e_1_3_2_5_2","first-page":"10539","article-title":"Primary merkel cell carcinoma of the oral mucosa: a case report with review of literature","volume":"10","author":"Son SM","year":"2017","unstructured":"Son SM, Woo CG, Kim KW, Lee HC, Lee OJ. 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