Abstract
Merkel cell carcinoma (MCC) is a rare cutaneous malignancy occurring mostly in older immunocompromized Caucasian males. A growing incidence of MCC has been reported in epidemiological studies. Treatment of MCC usually consists of surgical excision, pathological lymph node evaluation, and adjuvant radiotherapy. This paper reports the experience of a single tertiary center institution with 17 head and neck Merkel cell carcinoma patients. Median followup for the cohort was 37.5 months. After five years, recurrence-free survival, disease specific survival, and overall survival were 85%, 90%, and 83%, respectively. Our limited data support the use of adjuvant radiotherapy. We also report two cases of MCC located at the vestibule of the nose and two cases of spontaneous regression after diagnostic biopsy. About 40% of our patients were referred to our center for surgical revision and pathological lymph node evaluation. Increased awareness of MCC and an interdisciplinary approach are essential in the management of MCC.
Highlights
In 1875, Merkel, professor of anatomy at the University of Rostock, Germany, for the rst time described “Tastzellen”—later known as Merkel cells—in the epidermis of domestic animals and humans [1]
Treatment of MCC usually consists of surgical excision, pathological lymph node evaluation, and adjuvant radiotherapy. is paper reports the experience of a single tertiary center institution with 17 head and neck Merkel cell carcinoma patients
Diabetes was reported for one patient (6%); HIV/AIDS or immunosuppression a er organ transplant was not reported for any patients
Summary
In 1875, Merkel, professor of anatomy at the University of Rostock, Germany, for the rst time described “Tastzellen” (touch cells)—later known as Merkel cells—in the epidermis of domestic animals and humans [1]. In 1972, Toker rst reported a case series of ve patients with “trabecular carcinoma” and recognized a “distinct pathological entity,” with a “capricious clinical behaviour” [2]. It took Tang and Toker another six years to determine that trabecular carcinoma “most probably” derives from Merkel cells [3]. Known as Merkel Cell polyomavirus (MCV), this virus is thought to be a causative agent in MCC [5, 6] and has been associated with about 80% of MCC cases [4, 7,8,9,10]. Con icting evidence exists about the prognostic value of MCV status [7, 8, 12,13,14]
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