Merkel cell carcinoma: A series of seven cases (original) (raw)
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Clinical features and management of Merkel cell carcinoma
JPMA. The Journal of the Pakistan Medical Association, 2007
Merkel cell carcinoma (MCC) is an aggressive dermal tumour of neuroendocrine origin. MCC is a rare tumour and all information pertaining to its behaviour, therapy and prognosis is based on retrospective reports. The two potentially curative treatment modalities are surgery and radiotherapy. It is a rare, highly malignant primary skin tumour, originally called "trabecular carcinoma" of the skin. MCC poses a challenge to the clinician because of its rarity and poor prognosis. The optimal therapy is customised and tailored for each individual patient with the appropriate use of operative resection and radiation therapy. This review covers reports from several authors regarding the rationale of using postoperative radiotherapy to the primary tumour and regional lymphatics. Although MCC is classified as a type of neuroendocrine carcinoma, it is less likely to be controlled by systemic chemotherapy. Management of primary lesion with clinically localised disease is wide excision ...
Merkel cell carcinoma: a retrospective study on 48 cases and review of literature
Journal of oncology, 2012
Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor of the skin. Fourty-eight patients with MCC were observed at the Rare Hormonal Tumors Group of Cremona Hospital, 15 of these with unknown primary site. Due to rarity of Merkel cell carcinoma, clinical experience is generally limited. Data from our series confirm the current recommendations. Wide surgical excision must be associated with radiotherapy also in early stages in order to avoid local relapse and the rapid progression of disease. In advanced stages chemotherapy is the standard despite the short duration of responses and poor quality of life. The data of our series, characterized by a high demand for second opinion, offer some insight about the real rarity of the tumor, the difficulty of managing of disease in our country secondary to a wrong cultural approach to the problem, the indiscriminate use of molecules unnecessary and often expensive, the lack of protocols, and the presence of guidelines often...
Frontiers in Oncology
BackgroundMerkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin. The incidence of the disease has undergone a significant increase in recent years, which is caused by an increase in the average age of the population and in the use of immunosuppressive therapies. MCC is an aggressive pathology, which metastasizes early to the lymph nodes. These characteristics impose an accurate diagnostic analysis of the regional lymph node district with radiography, clinical examination and sentinel node biopsy. In recent years, there has been a breakthrough in the treatment of the advanced pathology thanks to the introduction of monoclonal antibodies acting on the PD-1/PD-L1 axis. This study aimed to describe the clinico-pathological characteristics, treatment strategies and prognostic factors of MCC.MethodsA retrospective cohort study was conducted involving 143 consecutive patients who were diagnosed and/or treated for MCC. These patients were referred to the Veneto Institute of...
Merkel cell carcinoma - description of five cases
Contemporary oncology (Poznań, Poland), 2013
Merkel cell carcinoma (MCC) is a rare but very aggressive skin cancer that derives from neuroendocrine cells of the skin. Merkel cell carcinoma morbidity has been continuously increasing for the last few years. Increasing reported incidence of MCC is probably connected with increasing occurrence of this kind of malignancy or with development of histological and immunohistochemical methods of sample examinations which have allowed for more precise diagnosis of skin tumor that might have previously not been accurately recognized. Merkel cell carcinoma develops as nodules early recognized as basocellular carcinoma, squamous cell carcinoma, amelanotic melanoma or skin lymphoma. Merkel cell carcinoma can be morphologically similar to skin metastasis as well as mild changes such as lipoma, cysts, fibroma or vessel changes. Accurate diagnosis is very important because it determines successful management and risk of progression of disease. We describe 5 patients with MCC who underwent surgi...
Indian Journal of Medical and Paediatric Oncology, 2008
Merkel cell carcinoma is a rare neuroendocrinal tumour of the skin. It is noted for its typical agg ressive nature unlike other skin tumours. Because of the rarity, the treatment is not standardised. Radiotherapy in the postoperative setting is effective in improving the loco regional control. A case of merkel cell carcinoma treated with postoperative radiotherapy is reported. Pertinent literature is reviewed.
Merkel Cell Carcinoma of the Face: Two Case Reports and Literature Review
Merkel cell carcinoma is an aggressive tumor of the skin deriving from neuroendocrine cells with unpredictable clinical behavior and poor clinical outcome. Merkel cell carcinoma is relatively rare with some 600 cases reported, but seemingly with an increasing incidence due to the increased sun exposure and immunosuppression. There are increasing reports of Merkel cell carcinoma occurring in transplant patients receiving immunosuppressive therapy. We present two cases of Merkel cell carcinoma of the facial skin, one of them in a patient who received immunosuppressive therapy. According to the literature, standard therapy for Merkel cell carcinoma includes large scale surgical excision of the primary tumor, neck dissection for palpable nodes, and in most cases subsequent radiotherapy. This article also reviews some recent reports of Merkel cell carcinoma regarding the diagnosis, clinical course and therapeutic modalities.
Radiotherapy for merkel cell carcinoma of the skin of the head and neck
Head & Neck, 1995
Background. Merkel cell carcinoma is a relatively rare neuroendocrine carcinoma of the skin. It arises in the head and neck region in approximately 50% of cases. Its aggressive behavior predisposes patients to local‐regional recurrence and distant metastases after surgical excision alone. In this article, we describe our experience with Merkel cell carcinoma of the head and neck.Methods. Of 18 patients with Merkel cell carcinoma treated in the Department of Radiation Oncology at the University of Florida, 12 patients who had primary tumors in the head and neck region are reported. Eight patients were treated at initial diagnosis (group A), and four were treated at the time of local‐regional recurrence (group B).Results. Local‐regional control was achieved in seven of eight patients in group A and all four patients in group B. One patient in group A and all patients in group B developed distant metastases and eventually died of their disease. Bone exposure developed in one patient, r...
Merkel cell carcinoma of an atypical presentation: A case report and literature review
Our Dermatology Online
Merkel cell carcinoma (MCC) is a primary cutaneous neuroendocrine carcinoma. It is a rare and aggressive tumor characterized by a high frequency of local recurrence, regional nodal metastasis, distant metastasis, and a low survival rate. Its diagnosis is challenging due to its rarity and it may be clinically mistaken for other skin cancers. It requires an incisional biopsy and confirmation by histology and immunohistochemical staining. This case illustrates an uncommon presentation of MCC in a 53-year-old young adult in an unexposed area of the right gluteal region. It is a rare cutaneous tumor that should be diagnosed and treated precociously given the aggressive nature of MCC and the limited therapeutic options for metastatic tumors. Herein, we urge physicians to suspect this diagnosis in front of any rapidly growing skin tumor, even in an unusual location, to provide the patient with appropriate treatment and improve the overall survival rate.
MERKEL CELL CARCINOMA: IMPROVED OUTCOME WITH ADJUVANT RADIOTHERAPY
ANZ Journal of Surgery, 2005
Background: Merkel cell carcinoma is an aggressive primary cutaneous neuroendocrine carcinoma. Patients remain at high risk of locoregional and distant relapse despite treatment. Most studies support the incorporation of locoregional adjuvant radiotherapy in reducing the risk of relapse. Methods: Between 1980 and 2002, 86 patients diagnosed with Merkel cell carcinoma were treated with curative intent at Westmead Hospital, Sydney. Multivariate analysis was performed using Cox regression analysis. Disease-free survival and overall survival was calculated using Kaplan-Meier survival curves. Results: Median age at diagnosis was 75 years (range 46-89 years) in 49 men and 37 women. Median duration of follow up was 31 months (range 6-153 months). Fifty-one (59%) patients presented with a primary lesion, 19 (22%) with a primary lesion and clinical nodal disease and 16 (19%) with lymph node metastases from an unknown primary. A total of 47 of 86 (55%) relapsed with regional nodal relapse, the commonest site of first relapse. Local relapse was similar for patients undergoing surgery (5/37; 14%) compared with surgery and adjuvant radiotherapy (3/25; 12%). Nodal relapse occurred in 14 of 36 (37%) treated with surgery compared with 7 of 38 (18%) patients treated with surgery and adjuvant radiotherapy. Patients treated with surgery and adjuvant radiotherapy experienced a better median disease free survival compared to those undergoing surgery alone (10.5 months vs 4 months; P < 0.01). The 5-year overall and disease-free survival rate for the entire study population was 47% and 25%, respectively. Twenty-six patients (30%) died as a result of Merkel cell carcinoma. Conclusion: Merkel cell carcinoma is an aggressive skin cancer. The addition of adjuvant radiotherapy markedly improves regional control rates and should be considered best practice.
Collegium antropologicum, 2012
Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin carcinoma. The purpose of this study is to describe clinical and pathological characteristics, diagnostic procedure and treatment outcomes of the patients with MCC of the head and neck treated in Otorhinolaryngology, Head and Neck Surgery Department of the University Hospital Center Zagreb between the years 2007 and 2011. Three patients with MCC of the head and neck were treated during this period. First patient was diagnosed with MCC of the left retroauricular region with metastases in the lymph nodes of the left side of the neck, pT2N2M0 Stage IIIB. Second patient was diagnosed with anaplastic carcinoma of the lower lip, pT1N1bM0 Stage IIIB and third patient was diagnosed with MCC of the face which was previously treated as benign lesion, cT1N1bM0 Stage IIIB. Two of the patients had second primary tumor of different histology. All of the patients were treated with wide surgical excision of the tumor and neck ...