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Merkel cell carcinoma: the clinical course
Annals of Plastic Surgery
|August 1, 1990
Summary
Merkel cell carcinoma, a rare neuroendocrine tumor, primarily affects women in their 60s, often presenting as a facial nodule. Survival rates are around 60% at three years, with some cases responding to surgery and radiotherapy.
Area of Science:
- Dermatology
- Oncology
- Neuroendocrinology
Background:
- Merkel cells, discovered in 1875, originate from neural crest cells and function as mechanoreceptors.
- Malignant transformation of Merkel cells can lead to tumors with neurosecretory granules, characteristic of APUDomas.
Observation:
- A literature search identified 121 cases of Merkel cell carcinoma.
- The most common presentation is an erythematous nodule on the face or lower limb.
- The condition predominantly affects women in their late 60s.
Findings:
- Regional lymph node involvement occurred in approximately 50% of patients.
- The three-year survival rate for Merkel cell carcinoma is around 60%.
- Two unusual cases of metastasizing Merkel cell carcinoma in older women showed positive response to combined surgery and radiotherapy.
Implications:
- This study highlights the typical clinical presentation and prognostic factors of Merkel cell carcinoma.
- The findings suggest that Merkel cell carcinoma, despite its rarity, warrants consideration in differential diagnoses for skin lesions.
- The reported successful treatment outcomes in advanced cases underscore the potential benefit of multimodal therapeutic approaches.