Search

Merkel cell carcinoma is a neoplasm originated from the neuroendocrine cells on the skin, on the basal layer. It was described by Toker, four decades ago, when he reported patients with this type of cancer. Although this is an uncommon neoplasm, its incidence has been increasing due to a higher exposure to sunlight, which is the most relevant risk factor for developing Merkel cell carcinoma. Sunlight exposure is also associated with a more aggressive and a rapid growth rate neoplasm. Since the description there has been several reports of spontaneous remission, in local tumors and with metastases, presenting certain factors that could promote this phenomenon, such as biopsy or the coinfection with a polyomavirus, in many of the cases without a recognized factor. This paper reports the case of a 59 yearold woman with Merkel cell carcinoma who presented spontaneous remission after incisional biopsy. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease occasionally associated with severe extra-articular manifestations, mostly in cases of longstanding highly active disease. We report the case of a 56 year-old woman diagnosed with active RA at the age of 40. After 5 years of high activity, her arthritis subsides spontaneously during pregnancy despite the lack of treatment with disease-modifying anti-rheumatic drugs. She remains without articular symptoms for 7 years, and then she develops a Felty's syndrome requiring steroid treatment and splenectomy. Following steroid withdrawal she develops pericarditis with massive serohematic pericardial effusion, still in absence of articular activity, and responds to immunosuppressive therapy and colchicine. We emphasize the unusual spontaneous and sustained joint remission without specific treatment, and the development of severe extra-articular manifestations of RA in absence of concomitant articular activity, as well as the importance of controlling inflammation. [ABSTRACT FROM AUTHOR]