Intracranial Spread of Merkel Cell Carcinoma to the Cerebellopontine Angle

Abstract

Merkel cell carcinoma (MCC) is a rare, highly malignant, and aggressive dermal neuroendocrine neoplasm that rarely metastasizes to the central nervous system. To review the current literature regarding treatment of neurometastatic MCC. A case of a 78-year-old male with intracranial extra-axial metastatic MCC involving the left cerebellopontine angle is presented. A retrosigmoid craniectomy was performed with complete resection of the metastatic focus. Adjuvant treatment included whole-brain radiation therapy followed by etoposide and carboplatin chemotherapy. Seven months postoperatively, the patient was free of metastatic disease. Surgical resection should be performed when feasible to prevent local recurrence. This may be followed by early adjuvant fractionated whole-brain radiotherapy and systemic chemotherapy; however, no clinical trials have been performed to demonstrate a survival benefit.