Background: Merkel cell carcinoma (MCC) is a relatively rare and aggressive cutaneous neuroendocrine malignancy characterized by high incidence of local recurrence, distant metastases, regional nodal metastases, and high mortality. Clinically, MCC presents as a persistent asymptomatic red/pink shaped nodule, usually smaller than 2 cm with nontender intracutaneous swelling, with rapidly growing localized disease with lymph node metastases preceding distant metastases. Because of its rare nature and the lack of comprehensive understanding of the disease, management of MCC has been controversial. Methods: An 87-year-old retired Caucasian male with a history of tobacco use, chronic sun exposure, and multiple squamous and basal cell carcinomas presented with a 1.8 × 1.3 cm red, nontender nodule on the dorsum of the proximal phalanx of the left long finger first noticed 6 months prior to presentation. Biopsy was consistent with MCC after which he was treated with wide local excision, full-thickness skin grafting, and sentinel lymphadenectomy (1/4 nodes positive) followed by adjuvant radiation therapy. Results: He recovered appropriately and was clinically and radiographically disease free at 2.5-year follow-up. Conclusion: Although it remains rare, MCC has increased in incidence over the last several decades and has a predilection to occur over sun exposed areas. Highly aggressive, it has a high incidence of regional and distant metastasis as well as local recurrence. As a result, it is important that practitioners involved in the care of skin and hand lesions be aware of this condition and the need for a multidisciplinary treatment approach.
Background: Merkel cell carcinoma (MCC) is a relatively rare and aggressive cutaneous neuroendocrine malignancy characterized by high incidence of local recurrence, distant metastases, regional nodal metastases, and high mortality. Clinically, MCC presents as a persistent asymptomatic red/pink shaped nodule, usually smaller than 2 cm with nontender intracutaneous swelling, with rapidly growing localized disease with lymph node metastases preceding distant metastases. Because of its rare nature and the lack of comprehensive understanding of the disease, management of MCC has been controversial. Methods: An 87-year-old retired Caucasian male with a history of tobacco use, chronic sun exposure, and multiple squamous and basal cell carcinomas presented with a 1.8 × 1.3 cm red, nontender nodule on the dorsum of the proximal phalanx of the left long finger first noticed 6 months prior to presentation. Biopsy was consistent with MCC after which he was treated with wide local excision, full-thickness skin grafting, and sentinel lymphadenectomy (1/4 nodes positive) followed by adjuvant radiation therapy. Results: He recovered appropriately and was clinically and radiographically disease free at 2.5-year follow-up. Conclusion: Although it remains rare, MCC has increased in incidence over the last several decades and has a predilection to occur over sun exposed areas. Highly aggressive, it has a high incidence of regional and distant metastasis as well as local recurrence. As a result, it is important that practitioners involved in the care of skin and hand lesions be aware of this condition and the need for a multidisciplinary treatment approach.
Authors: Bianca D Lemos; Barry E Storer; Jayasri G Iyer; Jerri Linn Phillips; Christopher K Bichakjian; L Christine Fang; Timothy M Johnson; Nanette J Liegeois-Kwon; Clark C Otley; Kelly G Paulson; Merrick I Ross; Siegrid S Yu; Nathalie C Zeitouni; David R Byrd; Vernon K Sondak; Jeffrey E Gershenwald; Arthur J Sober; Paul Nghiem Journal: J Am Acad Dermatol Date: 2010-06-19 Impact factor: 11.527
Authors: J Ortin-Perez; M C van Rijk; R A Valdes-Olmos; S Vidal-Sicart; O E Nieweg; A Vilalta; B B R Kroon; F Pons Journal: Eur J Surg Oncol Date: 2006-10-17 Impact factor: 4.424
Authors: Mireille Van Gele; J Helen Leonard; Nadine Van Roy; Heidi Van Limbergen; Simon Van Belle; Veronique Cocquyt; Helen Salwen; Anne De Paepe; Frank Speleman Journal: Int J Cancer Date: 2002-09-10 Impact factor: 7.396
Authors: Michelle Heath; Natalia Jaimes; Bianca Lemos; Arash Mostaghimi; Linda C Wang; Pablo F Peñas; Paul Nghiem Journal: J Am Acad Dermatol Date: 2008-03 Impact factor: 11.527