An unusual neoplasm of the pancreas: Pancreatic metastasis of a Merkel cell carcinoma. Case report and review of the literature.

Isolated pancreatic metastases are rare. The differential diagnosis of pancreatic neoplasms can be difficult, especially it can be troublesome to obtain tissue diagnosis. However, pancreatic lesions in patients with a history of a malignancy must be considered to be metastases. We present a case of a patient with a history of a Merkel cell carcinoma (MCC) in the neck. Twelve months after this diagnosis a follow-up CT shows a large isolated tumor in the head of the pancreas. Histological and immunohistochemical studies of specimen obtained through ultrasound-guided transabdominal biopsy, show similar characteristics as the primary MCC. To our knowledge twelve cases of a pancreatic metastasis of a MCC have been reported in English literature. A review of the literature was performed.

Ontogeny of cholecystokinin receptors in the human striatum.

The distribution of cholecystokinin binding sites was studied by receptor autoradiography in the human striatum at midgestation, birth and adulthood. In the adult, cholecystokinin receptors are inhomogeneously distributed with patches of reduced labeling. In the caudate nucleus but not in the putamen these patches match the striosomal organization as revealed by acetylcholinesterase staining. At midgestation, patches of high density of cholecystokinin receptors are in register with the dopamine D1 receptor-enriched striosomes. At birth, this striosomal organization has already evolved into the adult pattern of higher matrix level in contrast to the striosomal pattern of acetylcholinesterase staining.

Mucorales and deferoxamine: from saprophytic to pathogenic state.

Rhinocerebral mucormycosis can be a rapidly fatal course disease if the institution of treatment is delayed. We describe a case of a long-term dialysis patient in which the role of a siderophore such as Deferoxamine in promoting mucormycosis is discussed. The frequent lack of early diagnosis, itself subsequent to a break away from the standard diagnostic tools (apart from biopsy and culture) makes the survival prognosis particularly critical.