[Cardiac metastasis from a Merkel cell skin carcinoma. A case report]. / Métastase cardiaque d'un carcinome cutané à cellules de Merkel. A propos d'un cas.

The authors report the case of a cardiac metastasis of a Market cell skin tumour in a 72 year old woman, presenting with chest pain and infero-lateral myocardial ischaemia simulating an acute coronary syndrome. The diagnosis, suspected on echocardiography, was confirmed by thoracic CT scan. Markel cell carcinoma is a rare skin tumour classified among the malignant neuroendocrine tumours. It has a high metastatic potential, especially to the gastrointestinal tract and the lung. On the other hand, cardiac metastases are quite exceptionally rare.

[Spinal leptomeningeal tumor spread disclosing a pineocytoma]. / Essaimage tumour leptomeninge spinal révélateur d'un pineocytome.

A 39-year-old female was admitted to the hospital because of a sudden meningeal syndrome followed by diplopia, cervical, dorsal and sciatic nerve pains, and right peripheral facial palsy. Cerebrospinal fluid obtained by lumbar puncture showed a protein level at 23 g/l. Myelography and magnetic resonance imaging (MRI) were in favor of a lumbar arachnoiditis. A meningeal biopsy revealed a tumour infiltration with foci of cells that were stained with anti-glial fibrillary acidic protein antibody. Cerebral MRI was performed to search for a central nervous system (CNS) primary tumour, and disclosed a pineal mass. Five months after the onset of the disease, the patient worsened her clinical state and died. Necropsy confirmed the presence of a pineocytoma with astrocytic differentiation and diffuse leptomeningeal spread. This exceptional occurrence leads us to discuss about primary tumours of the CNS with leptomeningeal spread.