CUTANEOUS NEUROENDOCRINE (MERKEL CELL) CARCINOMA - A REPORT OF 35 CASES

Cutaneous neuroendocrine (Merkel cell) cancer (CNEC) is a rare skin tu mor with a highly malignant nature. Initial treatment of this tumor ha s often been limited to a local excision. The medical records of 35 pa tients diagnosed with CNEC and treated at Southern California Kaiser P ermanente Medical Group or UCLA Medical Center between 1980 and 1991 w ere reviewed. There were 26 male and 9 female patients were enrolled i n this study. Minimum follow-up from date of diagnosis was 18 months, mean follow-up was 40 months; 25 patients presented with local disease (stage I) and 10 patients presented with regional disease (involved n odes, stage II). Patients who were treated initially with local therap y alone had a 65% recurrence rate and a 29% mortality rate, while thos e patients treated locoregionally at presentation had only a 27% recur rence rate and 14% mortality rate, although the majority presented wit h more advanced disease. Due to the high incidence of lymph node failu re and death in patients treated locally versus locoregionally at pres entation, we feel that planned locoregional treatment is indicated for all patients presenting with CNEC, regardless of stage.