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Merkel Cell Carcinoma

Aggressive neuroendocrine skin cancer driven by polyomavirus or ultraviolet damage

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Merkel Cell Carcinoma?

Merkel cell carcinoma typically appears as a rapidly growing painless red or violet nodule on sun-exposed skin of older or immunosuppressed adults. Most cases harbor clonally integrated Merkel cell polyomavirus DNA and an associated viral protein expression pattern, while ultraviolet-driven cases show high mutation burden.

Local treatment includes wide excision with one to two centimeter margins and sentinel lymph node biopsy because lymph node metastasis is common at presentation. Adjuvant radiotherapy to the primary site and draining nodal basin reduces local recurrence and improves outcomes.

Advanced or metastatic disease responds to programmed death ligand 1 and programmed death 1 inhibitors with durable remissions in nearly half of patients. Avelumab and pembrolizumab are widely used and have transformed prognosis compared with platinum-based chemotherapy.

Symptoms

Rapidly enlarging painless skin nodule
Reddish or violet color on sun-exposed skin
Predilection for head, neck, and limbs
Regional lymphadenopathy at diagnosis
Recurrence within months of inadequate excision

Risk Factors

Older adult age and fair skin
Chronic ultraviolet exposure or photochemotherapy
Solid organ transplantation or immunosuppression
Human immunodeficiency virus infection
Hematologic malignancy with immune impairment

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When a new rapidly growing skin nodule appears
  • When a previously stable lesion enlarges quickly
  • When regional lymph nodes are palpable
  • When immunosuppressed patients note skin changes
  • When recurrence is suspected after prior treatment

Treatment Methods

01
Wide local excision with sentinel lymph node biopsy
02
Adjuvant radiotherapy to primary and nodal basin
03
Avelumab or pembrolizumab for advanced disease
04
Salvage chemotherapy with platinum and etoposide
05
Imaging surveillance with computed tomography or positron emission tomography
06
Sun protection education and skin self-examination
07
Multidisciplinary review with dermatology and oncology

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.