[A metastatic Merkel cell carcinoma successfully treated with chemotherapy]

A 68-year-old man referred to the hospital because of a swelling of his bilateral cervical, left supraclavicular, and left axillary lymph nodes, and an ulcerated tumor in the right palatine tonsil. Three years previously, he had undergone a local excision in the left forearm of a skin tumor that had been pathologically diagnosed as a Merkel cell tumor. CT scan demonstrated an abdominal mass and his serum neurospecific-enolase (NSE) was found to be 20.3 ng/ml. Following biopsies of the lymph nodes and the tumor in the right tonsil, a metastatic Merkel cell carcinoma was diagnosed. Systemic chemotherapy thus was begun with doses of cyclophosphamide, doxorubicin and vincristine. After three cycles were completed, tumor were no longer present and his NSE returned to normal. Three months after the discontinuance of chemotherapy, he remains disease-free.