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    A rare Merkel cell carcinoma (MCC) case in a 92-year-old man was successfully treated with wide excision and adjuvant radiation. Early detection and treatment led to a favorable outcome without metastatic disease.

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    Area of Science:

    • Dermatology
    • Oncology
    • Pathology

    Background:

    • Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer.
    • Older adults are at higher risk for developing MCC.
    • Early diagnosis and treatment are crucial for improving patient outcomes.

    Observation:

    • A 92-year-old male presented with a rapidly growing, asymptomatic pink nodule on his forearm.
    • Biopsy confirmed Merkel cell carcinoma (MCC).
    • Immunohistochemistry showed characteristic MCC markers (CK20+, CKAE1/AE3+, NSE+, S-100-).

    Findings:

    • Positron emission tomography (PET) revealed no evidence of metastatic disease.
    • Wide excision and sentinel lymph node biopsy were performed.
    • Sentinel nodes were negative for MCC.
    • Adjuvant radiation therapy was administered due to close deep margins (MCC within 2 mm).

    Implications:

    • This case highlights the importance of prompt evaluation for suspicious skin lesions, even in the elderly.
    • Multidisciplinary treatment approach (surgery, radiation) can achieve favorable outcomes for localized MCC.
    • Sentinel lymph node biopsy is valuable in staging and guiding treatment decisions for MCC.