MERKEL CELL-CARCINOMA OF THE SKIN - IMAGING AND CLINICAL-FEATURES IN 93 CASES

Clinical, pathological and imaging data for 93 patient with Merkel cel l carcinoma were reviewed. Median survival duration from the date of d iagnosis was estimated using the Kaplan-Meier product-limit method. Su rvival durations of patients with no metastastic disease, with regiona l lymph node metastasis only and with distant metastases were compared using the Cox-Mantel log-rank rest, The median age for patients with Merkel cell carcinoma was 70 years (range 35-91 years) The tumour occu rred in 71 men and 22 women. The most common primary site was the head and neck region (64 patients). followed by the extremities (21 patien ts) and the trunk (10 patients). Median survival duration for the whol e group was 33 months (range 2-140 months). Imaging studies of the pri mary sites were available for 10 patients and of metastatic sites for seven patients. Sonograms of the primary skin lesions showed single or multicentric hypoechoic nodules arising from the dermis and growing i nto the subcutaneous tissues. CS scans showed single or multiple minim ally enhancing soft tissue nodules. in two instances associated with l yric bone erosion. The metastatic lesions were moderately hypoechoic o n sonography and target-shaped with or without ring-enhancement on CT. Imaging studies have a limited role in diagnosis of the clinically ev ident primary skin lesions but ma! be helpful in the assessment of the depth of the invasion and are crucial in the evaluation of regional a nd distant metastatic disease. If regional adenopathy is found then CT of the cheat. abdomen and pelvis may be in order.