Merkel cell carcinoma in a liver transplant patient.

Merkel cell carcinoma (MCC) is an aggressive tumor, the incidence of which is seemingly increased in immunocompromised patients. We report on a new case of MCC occurring in a 69-year-old male liver transplant recipient 6.5 years after transplantation. The outcome was marked by early skin and lymph node relapses treated by radiotherapy alone, and the patient ultimately died 30 months after first diagnosis. Together with data from the literature, this case emphasizes the importance of early diagnosis and adequate management of this aggressive disease for which wide initial surgical excision, accurate staging, and close follow-up are of critical importance to outcome, especially in this setting of immunosuppressive treatment, which is usually associated with a higher rate of recurrence.