Adjuvant Radiotherapy for Dissected Parotid Lymph Nodes Containing Merkel Cell Carcinoma from an Unknown Primary Skin...

Area of Science:

• Oncology
• Radiotherapy
• Surgical Oncology

Background:

• Merkel cell carcinoma (MCC) is an aggressive neuroendocrine malignancy with rising incidence.
• Optimal management of MCC necessitates a multidisciplinary approach.
• Adjuvant radiotherapy is a common therapeutic strategy for MCC.

Approach:

• Literature review indicating potential benefits of aggressive adjuvant radiotherapy for MCC.
• Case report 1: 75-year-old male with parotid MCC, treated with 61.2 Gy adjuvant radiotherapy, remained disease-free for 10 years.
• Case report 2: 73-year-old female with metastatic parotid MCC, treated with 56 Gy adjuvant radiotherapy, remained disease-free for 14 months.

Key Points:

• Metastatic MCC in parotid lymph nodes without a primary skin tumor is rare.
• Adjuvant radiotherapy to the tumor bed and regional nodal basin may prevent recurrence.
• Effective local control achieved with adjuvant radiotherapy in presented cases, despite refusal of chemotherapy in one instance.

Conclusions:

• Adjuvant radiotherapy to the tumor bed and regional nodal basin may be beneficial in preventing disease recurrence in metastatic MCC of the parotid lymph nodes.
• This strategy shows promise even in the absence of systemic medical therapy.
• Long-term disease-free survival observed in cases treated with adjuvant radiotherapy.