Merkel cell carcinoma: a primer for the radiologist

Area of Science:

• Oncology
• Dermatology
• Nuclear Medicine

Background:

• Merkel cell carcinoma (MCC) is a rare but aggressive cutaneous neuroendocrine cancer.
• Early detection and accurate staging are critical for effective management of MCC.
• Treatment strategies for MCC are evolving, necessitating updated clinical guidance.

Purpose of the Study:

• To provide a comprehensive overview of the current staging, workup, treatment, and follow-up protocols for Merkel cell carcinoma.
• To consolidate essential information for clinicians managing patients with MCC.
• To highlight the importance of multidisciplinary care in optimizing outcomes for MCC patients.

Main Methods:

• Review of current literature and clinical guidelines on Merkel cell carcinoma.
• Synthesis of information regarding diagnostic imaging, surgical techniques, radiotherapy, and systemic therapies.
• Emphasis on sentinel lymph node biopsy and PET/CT imaging in staging.

Main Results:

• Sentinel lymph node mapping and PET/CT are essential for accurate staging of MCC.
• Radiotherapy is a crucial component of MCC management due to its radiosensitivity.
• Close surveillance with PET/CT aids in the early detection of MCC recurrence.

Conclusions:

• Sentinel lymph node mapping and PET/CT are the cornerstones of MCC staging.
• Radiotherapy plays a significant role in the multidisciplinary management of MCC.
• Regular follow-up using PET/CT is vital for monitoring treatment response and detecting recurrences.