• Feng-Wei Kong, Miao Zhang, Heng Wang, Cun-Tao Lu, Wen-Bin Wu, and Yuan-Yuan Liu.
• aDepartment of General Surgery, Xuzhou Infectious Disease Hospital bDepartment of Thoracic Surgery cDepartment of Respiratory Medicine, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou, China.
• Medicine (Baltimore). 2017 Nov 1; 96 (46): e8743.

RationaleMerkel cell carcinoma (MCC) is an aggressive neuroendocrine-derived cutaneous cancer. Ectopic or single metastatic MCC located in thorax is extremely rare; meanwhile, its definite management has not been elucidated yet.Patient ConcernsA 64-year-old female patient with a giant mass located in her left thorax was presented for stuffy pain of left chest for 6 months and fever for half a month. She underwent radical resection of vulvar MCC 10 years ago.DiagnosesComputed tomography (CT)-guided biopsy of the intrathoracic mass revealed a diagnosis of MCC, without synchronous urogenital lesions on pelvic CT images.InterventionsThis bulky tumor was completely resected via thoracotomy, along with the adjacent pulmonary lobe, pericardium, pleura, and diaphragm.OutcomesThe patient survived without local-regional recurrence or distant metastasis during the follow-up of 1 year up to now.LessonsEctopic or single metastatic MCC should be considered in the differential diagnosis of intrathoracic tumors, especially in patients with a history of MCC. Besides, a timely surgery combined with chemotherapy is effective for this disease.

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