MERKEL CELL-CARCINOMA

Merkel cell carcinoma is a rare malignant tumor of the skin with predo minance in older patients; 78.6% of patients are older than 59 years. Female and male patients are equally involved in the age group below 6 0 years. After 60 years, Merkel cell carcinomas are more often observe d in female patients. The tumor is most often located in the head and neck region (50.8%) or the extremities (33.7%). The average size is 29 mm at presentation. Clinically, only a presumptive diagnosis of Merke l cell carcinoma can be established. The definite diagnosis is made by histological, especially immunohistological methods (detection of int ermediate filaments and neuroendocrine markers). The therapy of choice is local excision. Secondary therapy may be a combination of operatio n and radiation or chemotherapy. Since this combination may reduce the risk of recurrences it should be applied for patients with poor progn ostic features. Especially in young patients, additional lymphadenecto my should be discussed. Clinical control is necessary. Distant metasta ses should be treated by chemotherapy. Bad prognostic features are: ly mph node metastasis, size larger than 2 cm, male sex.