Merkel cell carcinoma

Merkel Cell Carcinoma (MCC) is a rare and aggressive neuroendocrine dermal neoplasm. This study is a retrospective outcomes analysis of two cases of MCC with data regarding clinical, histopathological, immunohistochemistry and also surgical, chimio and radiological treatment. MCC is a rare dermal tumors, this tumors are most predictable found on sunexposed sites. Diagnosis is best accomplished by a thorough clinical evaluation coupled with light microscopy and defined panel of immunohistochemical studies which are necessary for the definitive diagnosis of Merkel cell carcinoma (cytokeratins, neuron specific enoiase and chromogranin). A lot of other disease must be included in the differential diagnosis. MCC is an aggressive tumor with local or locoregionale extension and distant spread by hematogen or lymphatic way. Surgical excision of tumor and regional lymphadenectomy is the first step of treatment completed with radiotherapy and chemotherapy bat in advanced studies the rate of local or distant recidives is high.     

Merkel cell carcinoma

A rare, primary, malignant carcinoma of the skin exists of which the Merkel cell has been implicated as the cell of origin. Until recently, reports of this cancer were sparse. A review of the literature is presented along with a case report in which the primary tumor occurred on the lower leg.     

Merkel cell carcinoma of the ear

All the consultants agree that, given this patient's history, a common skin tumor like squamous cell or basal cell carcinoma is unlikely. Melanoma or Merkel cell carcinoma belong in the differential. Interestingly, the consultants all suggest a biopsy of the lesion prior to other testing, and because this tumor is so accessible, a biopsy should not interfere with further testing or treatment. Drs. Weymuller and Marks would then proceed with a CT scan; Dr. Ridge favors an MRI scan. While a chest-ray is in order to rule out metastases, Dr. Weymuller also suggests immunocytochemistry. All the experts agree that the primary tumor should be excised. Dr. Weymuller would perform a total parotidectomy with facial nerve preservation, while Drs. Marks and Ridge suggest a superficial parotidectomy with facial nerve preservation. Drs. Weymuller and Ridge would also perform a modified radical neck dissection. In the absence of cervical disease, Dr. Marks would treat the neck primarily with radiotherapy. Only Dr. Weymuller favors immediate reconstruction and would use a lower trapezius island flap or a large rotational flap. Drs. Marks and Ridge prefer primary closure or skin graft. Drs. Weymuller and Ridge would treat this patient with combined therapy, giving radiotherapy to the primary area and the neck postoperatively at a dose of 55-60 Gy. However, Dr. Marks would treat the primary site postoperatively and the neck primarily with radiotherapy. He would treat the primary site with 59.40 Gy and the neck with 50.40 Gy.(ABSTRACT TRUNCATED AT 250 WORDS)     

Rising incidence of Merkel cell carcinoma

Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark, and to investigate the incidence. We suggest guidelines for treatment. First we reviewed the medical records of 51 patients diagnosed with MCC from 1995 until 2006 in eastern Denmark. The nation-wide incidence of MCC was extracted from the Danish Cancer Registry for the calculations for the period 1986-2003. We reviwed published papers about MCC based on a MEDLINE search. Fourteen of the 51 patients developed recurrence, and 37 (73%) died during the study period. Mean follow-up was 13 months (range 1-122). A total of 153 patients were identified in the Danish Cancer Registry, and showed that incidence rates had increased 5.4 fold over the 18 year period from 1986 until 2003. Rates were highest in people over the age of 65. Recommended treatment with curative intent includes excision of the primary tumour with wide margins, excision of the sentinel node, computed tomogram (CT) or positron emission tomography (PET) of the thorax and abdomen, and adjuvant radiotherapy to the surgical bed. In the case of advanced disease, systemic palliative chemotherapy remains a possibility. There is a need for prospective multicentre evaluation of staging investigations and treatment of MCC.     

Brain metastasis of Merkel cell carcinoma

Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumor that is locally aggressive and has potential for metastatic spread. However, brain metastases are rare, and therapy for such tumors has never reported. The authors present a 48-year-old woman with MCC of the left elbow and a right cerebellar metastasis. After the right cerebellar mass was totally resected, radiation treatment and chemotherapy were performed. Eight cases of brain metastasis have been reported in the literature, but only 5 have been presented in sufficient detail for analysis. Therapy for brain metastases has always been palliative whole-brain irradiation and chemotherapy except for our patient, who underwent total removal of the tumor and survived for 11 months without neurological deficit. Except in the case of 1 with a particularly radiosensitive MCC, the patients with brain metastases died within 9 months after detection of the brain lesions. If possible, aggressive excision of brain metastases as well as of the primary lesion should be done.     

Rising incidence of Merkel cell carcinoma

Abstract

Merkel cell carcinoma (MCC) is a rare, aggressive, skin cancer of obscure histogenesis, the incidence of which is rising. There is no consensus on the optimal treatment. Our aim was to evaluate the staging, investigation, treatment, and follow-up of MCC in eastern Denmark, and to investigate the incidence. We suggest guidelines for treatment. First we reviewed the medical records of 51 patients diagnosed with MCC from 1995 until 2006 in eastern Denmark. The nation-wide incidence of MCC was extracted from the Danish Cancer Registry for the calculations for the period 1986-2003. We reviwed published papers about MCC based on a MEDLINE search. Fourteen of the 51 patients developed recurrence, and 37 (73%) died during the study period. Mean follow-up was 13 months (range 1–122). A total of 153 patients were identified in the Danish Cancer Registry, and showed that incidence rates had increased 5.4 fold over the 18 year period from 1986 until 2003. Rates were highest in people over the age of 65. Recommended treatment with curative intent includes excision of the primary tumour with wide margins, excision of the sentinel node, computed tomogram (CT) or positron emission tomography (PET) of the thorax and abdomen, and adjuvant radiotherapy to the surgical bed. In the case of advanced disease, systemic palliative chemotherapy remains a possibility. There is a need for prospective multicentre evaluation of staging investigations and treatment of MCC.     

Merkel cell carcinoma metastatic to testis

Merkel cell carcinoma is an uncommon, highly aggressive, neuroendocrine tumor that derives from cutaneous Merkel cells involved in proprioception. It is an extremely aggressive and rapidly fatal cancer. We report a rare case of Merkel cell carcinoma metastatic to the testis with prolonged survival.     

Merkel cell carcinoma of the head and neck

Merkel cell carcinomas are uncommon, but aggressive, cutaneous malignancies of neuroendocrine differentiation. To the pathologist, these lesions appear as sheets of undifferentiated tumor cells with little cytoplasm and dense nuclear chromatin. They are members of the group of "small round blue cell tumors," which includes small cell carcinomas of the lung, lymphomas, and neuroblastomas. Analogous to other skin malignancies, Merkel cell carcinomas frequently arise in the head and neck region and are commonly found in the elderly population. Merkel cell carcinomas have a high propensity for regional and distant metastases, and recurrences are frequently seen. Surgical excision is the recommended first-line treatment followed by adjuvant radiation therapy. Because of the high incidence of occult regional metastasis, patients with clinical and radioghaphically negative necks should undergo elective dissection, irradiation, or preferably sentinel lymph node biopsy.     

Merkel cell carcinoma. Prognosis and management.

Seventy patients with Merkel cell carcinoma were treated at Memorial Sloan-kettering Cancer Center between 1969 and 1989. The overall estimated 5-year survival rate was 64%. Factors predictive of improved survival included head and neck site and negative lymph nodes at presentation. Local recurrence was seen in 18 patients (26%) and did not correlate with patient-, tumor-, or treatment-related variables. Nine patients with local recurrence (50%) were free of disease following aggressive reoperation. Regional nodes were involved at some point during the course of the disease in forty-six patients (66%). Regional lymph node involvement was apparent within 2 years of diagnosis in 40 (87%) of 46 patients in whom it occurred. Systemic disease was nearly uniformly preceded by the appearance of nodal metastases and was uniformly fatal regardless of subsequent therapy. This suggests an orderly "cascade" pattern of spread for this tumor, in which elective regional lymph node dissection may be justified. Our recommendations for treatment include a wide excision of the primary tumor and either elective or early therapeutic regional node dissection. The role of adjuvant radiotherapy or chemotherapy remains unproven.     

Merkel cell carcinoma of the tongue base

Merkel cell carcinoma (MCC) is a rare but very aggressive tumour of neuroendocrine origin, usually seen in sun‐exposed parts of the body. Very few cases of MCC in the oral cavity have been reported. A new MCC case in the tongue base was reported in our hospital. Prompt diagnosis and early robotic surgery successfully removed the tumour with a clear margin for an early‐stage tumour.     

Merkel cell carcinoma: the clinical course

Merkel first discovered the cells named after him in the snout skin of voles in 1875. These cells are thought to originate from the neural crest and act as mechanoreceptors. When they have undergone malignant change, the neurosecretory granules in the cytoplasm may release various polypeptides, suggesting that the tumor is an APUDoma. In a computer search of the literature 121 cases were identified. It was revealed that the most common lesion is an erythematous nodule arising in the face or lower limb and occurring predominantly in women in their late 60s. The regional nodes became involved in half the patients, and the three-year survival was approximately 60%. Two unusual cases, in women 72 and 73 years old respectively, with metastasizing lesions that responded to a combination of surgery and radiotherapy are reported, and the literature is discussed.     

Cutaneous Merkel cell carcinoma: case report

Merkel cell carcinoma is an unusual cutaneous malignancy with a propensity for spreading to regional lymph nodes, with recurrence at original site or/and in lymph node. Occurring most often on the head and neck of the elderly patients. Complete surgical resection is the mainstay of treatment of the primary tumor. A case is here described of an old patient with more than one local relapse and in regional lymph nodes too, complete surgical resected, actually in good state of health, treated with radiotherapy.