Brain metastasis of Merkel cell carcinoma - Case report and review of the literature

Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumo r that is locally aggressive and has potential for metastatic spread. Howev er, brain metastases are rare, and therapy for such tumors has never report ed. The authors present a 48-year-old woman with MCC of the left elbow and a right cerebellar metastasis. After the right cerebellar mass was totally resected, radiation treatment and chemotherapy were performed. Eight cases of brain metastasis have been reported in the literature, but only 5 have b een presented in sufficient detail for analysis. Therapy for brain metastas es has always been palliative whole-brain irradiation and chemotherapy exce pt for our patient, who underwent total removal of the tumor and survived f or 11 months without neurological deficit. Except in the case of 1 with a p articularly radiosensitive MCC, the patients with brain metastases died wit hin 9 months after detection of the brain lesions. If possible, aggressive excision of brain metastases as well as of the primary lesion should be don e.