MERKEL CELL-CARCINOMA OF THE SKIN

Primary neuroendocrine carcinoma of the skin or Merkel cell carcinoma is an aggressive primary neoplasm. It is commonly seen in the elderly, on the head, neck and extremities, where it can mimic a benign or les s malignant skin tumour. Pathological examination shows a generally de nse growth of small dark cells, with immunohistochemical evidence of n euroendocrine differentiation. The microscopic appearance is very simi lar to metastatic oat cell carcinoma from the lung and this must be ex cluded by clinical means and appropriate imaging studies. In this stud y we present 13 new cases of Merkel cell carcinoma (the largest publis hed series in the UK) and summarize 214 cases from the literature in w hich the survival data are given. In our series, 5 of 13 patients died from spread of the Merkel cell carcinoma. From this and other studies , it appears that early diagnosis and wide local excision may be the o nly way to prolong survival. No other adjuvant therapy has proved effe ctive.