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PubMed - Merkel Cell Cancer (22 unread)

Upper lip nodule.

Fetched: May 14th, 2008, 9:00pm EDT

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Upper lip nodule.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 May;105(5):549-53

Authors: Chang JY, Stewart JM, Cheng YS, Wright JM

PMID: 18329908 [PubMed - indexed for MEDLINE]
Yuan Chang and Patrick Moore: teaming up to hunt down cancer-causing viruses.

Fetched: May 13th, 2008, 9:00pm EDT

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Yuan Chang and Patrick Moore: teaming up to hunt down cancer-causing viruses.

J Natl Cancer Inst. 2008 Apr 16;100(8):524-5, 529

Authors: Schmidt C

PMID: 18398088 [PubMed - indexed for MEDLINE]
Stathmin Expression in Pheochromocytomas, Paragangliomas, and in other Endocrine Tumors.

Fetched: May 8th, 2008, 9:00pm EDT

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Stathmin Expression in Pheochromocytomas, Paragangliomas, and in other Endocrine Tumors.

Endocr Pathol. 2008 May 7;

Authors: Sadow PM, Rumilla KM, Erickson LA, Lloyd RV

Pheochromocytomas are neuroendocrine tumors confined to the adrenal glands, and malignant pheochromocytomas can spread to various sites including the liver, lung, and bones. Paragangliomas occur in numerous locations in the body, so assessment of metastatic disease is more challenging, as patients with familial syndromes often have multiple, possibly independent paragangliomas. The most reliable criterion for malignancy in pheochromocytomas and paragangliomas is metastatic disease. Because there are few immunohistochemical markers that are useful in the diagnosis of malignancy in pheochromocytomas and paragangliomas before they metastasize, more markers are needed to characterize these tumors. Stathmin is a widely expressed 17-kDa cytoplasmic, microtubule destabilizing and sequestering phosphoprotein that is important in cell motility and cancer cell metastasis. It is upregulated in various malignancies. We examined stathmin expression in tissues from patients with pheochromocytomas (n = 48), malignant pheochromocytomas (n = 28), paragangliomas (n = 42), and malignant paragangliomas (n = 21) by immunohistochemistry using tissue microarrays (TMA) with a polyclonal antibody against stathmin. A series of other endocrine tissues and tumors (n = 70) were also examined for stathmin expression. Stathmin was more highly expressed in pheochromocytomas compared to normal adrenals, a finding confirmed by Western blot. There was higher expression of stathmin by immunohistochemical staining in malignant pheochromocytomas compared to pheochromocytomas without metastasis when analyzed by maximal staining (p = 0.012). Stathmin was present in a wide variety of endocrine tumors and was most highly expressed in rapidly proliferating tumors including anaplastic thyroid carcinomas, Merkel cell carcinomas of the skin and small cell carcinomas of the lung. These results show that stathmin is expressed at higher levels in more rapidly proliferating endocrine tumors. However, it is probably not useful as a stand-alone marker to determine malignancy in pheochromocytomas for individual tumors.

PMID: 18461287 [PubMed - as supplied by publisher]
Adding pathogens by genomic subtraction.

Fetched: May 1st, 2008, 9:00pm EDT

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Adding pathogens by genomic subtraction.

Nat Genet. 2008 Apr;40(4):380-2

Authors: MacConaill L, Meyerson M

PMID: 18368124 [PubMed - indexed for MEDLINE]
An unusual case of Merkel cell carcinoma.

Fetched: April 30th, 2008, 9:00pm EDT

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An unusual case of Merkel cell carcinoma.

J Cancer Res Clin Oncol. 2008 Feb;134(2):119-23

Authors: Strobel ES, Feyer P, Steingräber M, Schmitt-Gräff A, Kohl PK

PURPOSE: Merkel cell carcinoma (MCC) is a rare aggressive neuroendocrine tumor of the skin mainly found in elderly white patients. Due to its poor prognosis with distant metastases in up to 33% and local recurrence in 25-33% and a 5 year disease-specific survival of 64% (1-2) its early diagnosis and appropriate treatment is mandatory. METHODS: The study is an exceptional clinical case of a patient with a large inoperable MCC unable to be treated according to treatment guidelines due to her old age. We review the literature addressing treatment options. RESULTS: The patient was treated with palliative definitive radiotherapy to her large MCC of the left lower leg. She showed a rapid clinical response to four palliative radiation doses of 7 Gy each, necrosis of tumor mass and persistent clearing at a follow-up of 32 weeks. Our patient was very unusual in terms of her extensive MCC and her rapid and complete response to palliative radiotherapy lasting for 6 months at present. CONCLUSIONS: As MCC is an aggressive tumor, best survival is achieved with early diagnosis in a localized stage and prompt adequate surgery and further stage-adjusted treatment. Thus, the differential diagnosis of MCC should not be dismissed in a reddish nodule on the leg, and every excision should be submitted to pathology. In accordance with the literature we demonstrate here that definitive radiotherapy is an effective treatment option for inoperable MCC, which in this individual patient produced necrosis of the extensive tumor mass after only four palliative doses.

PMID: 17653576 [PubMed - indexed for MEDLINE]
Vascular changes in merkel cell carcinoma based on a histopathological study of 92 cases.

Fetched: April 18th, 2008, 9:00pm EDT

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Vascular changes in merkel cell carcinoma based on a histopathological study of 92 cases.

Am J Dermatopathol. 2008 Apr;30(2):106-11

Authors: Vazmitel M, Michal M, Shelekhova KV, Sima R, Mukensnabl P, Kazakov DV

Although prominent vascular proliferation is a known feature of various neuroendocrine tumors, it has not been systematically studied in Merkel cell carcinoma (MCC) of the skin. The purpose of this study was to fully characterize the light microscopic, immunohistochemical, and ultrastructural features of vascular changes associated with MCC and to determine their frequency and differential diagnostic implications. Additionally, the presence of human herpesvirus 8 DNA in the lesional tissue was investigated. Of 92 studied cases of MCC, 18 cases (20%) were found to exhibit foci of prominent vascular changes which were classified into the following 6 patterns: pericyte hyperplasia, pyogenic granuloma-like, hemangioendothelioma-like, epithelioid hemangioma-like, peliosis-like, and follicular dendritic cell tumor-like pattern. In addition, Azzopardi phenomenon was observed. These changes occurred singly or in combination. Human herpesvirus 8 DNA was identified by polymerase chain reaction in none of the 18 cases. It is concluded that prominent vascular proliferations may be seen in 20% of MCC, and thereby, MCC resembles neuroendocrine tumors in other organs. When unduly prominent and encountered in a limited biopsy specimen, vascular alterations may represent a potential diagnostic pitfall, but, on the other hand, they themselves may serve as a clue to the correct diagnosis. Human herpesvirus 8 does not play a role in angiogenesis in MCC.

PMID: 18360111 [PubMed - indexed for MEDLINE]
Expression of VEGF-A/C, VEGF-R2, PDGF-alpha/beta, c-kit, EGFR, Her-2/Neu, Mcl-1 and Bmi-1 in Merkel cell carcinoma.

Fetched: April 15th, 2008, 9:00pm EDT

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Expression of VEGF-A/C, VEGF-R2, PDGF-alpha/beta, c-kit, EGFR, Her-2/Neu, Mcl-1 and Bmi-1 in Merkel cell carcinoma.

Mod Pathol. 2008 Apr 11;

Authors: Brunner M, Thurnher D, Pammer J, Geleff S, Heiduschka G, Reinisch CM, Petzelbauer P, Erovic BM

Merkel cell carcinoma is a rare but very aggressive tumor of the skin. With current treatment options, Merkel cell carcinoma is associated with a high incidence of recurrence and metastasis. Targeted anticancer therapies such as receptor tyrosine kinase inhibitors and antisense oligonucleotides have been found to be a promising new type of treatment for various types of cancer. To evaluate whether the use of targeted therapies is a possible treatment option in Merkel cell carcinoma, we determined the expression of the target molecules c-kit, Mcl-1, Bmi-1, vascular endothelial growth factor (VEGF)-A, VEGF-C, VEGF-receptor 2 (VEGF-R2), platelet-derived growth factor (PDGF)-alpha, PDGF-beta, epidermal growth factor receptor (EGFR) and Her-2/Neu in a tissue microarray of 32 samples of 29 patients with Merkel cell carcinoma. C-kit-positive samples were analyzed for mutations in exons 9 and 11. The tissue microarray was stained immunohistochemically with antibodies directed against the above-mentioned proteins, and an immunoreactivity score was calculated. DNA was extracted from c-kit-positive samples and was analyzed for exon 9 and 11 mutations using direct DNA sequencing. We found that c-kit (7%), Mcl-1 (88%), Bmi-1 (78%), VEGF-A (91%), VEGF-C (75%) VEGF-R2 (88%), PDGF-alpha (72%) and PDGF-beta (13%) were expressed in Merkel cell carcinomas. All samples showed a lack of EGFR and Her-2/Neu expression. Analysis of c-kit revealed no mutations. As VEGF-A, VEGF-C, VEGF-R2, PDGFs and c-kit are targets of new cytostatic agents used in the treatment of other cancers, inhibition by a multitargeted chemotherapy could be a very promising treatment option. High expression of Bmi-1 and Mcl-1 warrants further studies on the use of antisense oligonucleotides in Merkel cell carcinoma.Modern Pathology advance online publication, 11 April 2008; doi:10.1038/modpathol.2008.63.

PMID: 18408656 [PubMed - as supplied by publisher]
Management of Merkel tumours: an evidence-based review.

Fetched: April 10th, 2008, 9:00pm EDT

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Management of Merkel tumours: an evidence-based review.

Curr Opin Oncol. 2008 May;20(3):280-6

Authors: Henness S, Vereecken P

(1) Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer of neuroendocrine origin generally seen in patients over 50 years of age. It has a high propensity for recurrence post-treatment; 5-year overall survival rates range from 23% to 80%. (2) The rarity of MCC means that there is a lack of prospective controlled trials in these patients. Patients are generally treated with surgery as a first-line therapy, supplemented with adjuvant radiotherapy and chemotherapy if required. (3) The use of adjuvant therapies in MCC remains controversial. Data from case series and meta-analyses of case series suggest that the addition of radiotherapy to surgery in patients with MCC can confer significant benefits with regard to reducing local and regional recurrence rates and prolonging disease-free survival. Generally, the current literature tends not to support the use of chemotherapy in these patients. (4) Stage-specific treatment regimens have been outlined involving various combinations of surgery, radiation and chemotherapy for International Union Against Cancer (UICC) stage I to III disease, while the emphasis of treatment in patients with UICC stage IV disease is on palliative care with or without radio- or chemotherapy. There is a need for more structured clinical research to better illuminate the most effective treatments for this disease.

PMID: 18391627 [PubMed - in process]
Deaths from non-melanoma skin cancer in Western Australia.

Fetched: April 4th, 2008, 9:00pm EDT

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Deaths from non-melanoma skin cancer in Western Australia.

Cancer Causes Control. 2008 Apr 2;

Authors: Girschik J, Fritschi L, Threlfall T, Slevin T

OBJECTIVES: Non-melanoma skin cancer (NMSC) is common, slow growing, and rarely metastasizes. However, there are still nearly 400 deaths from NMSC in Australia annually. We aimed to investigate the accuracy of NMSC death coding and to describe the characteristics of these deaths and the potential for prevention. METHODS: Histology reports for all deaths coded as NMSC (ICD-10 C44.0-C44.9) by the Western Australian Cancer Registry for the years 1996-2005 were reviewed for type of cancer, body site (primary tumor and metastases), and level of available documentation. RESULTS: Of 368 deaths recorded as being due to NMSC only 3 were found to be miscoded. An additional 53 deaths contained inadequate information to confirm NMSC as the cause of death. Of the confirmed cases, 219 were due to squamous cell carcinoma, 53 to Merkel cell carcinomas, and 40 to other skin cancers. Cases were mainly males and were elderly. Most of the primary squamous and Merkel cell carcinomas were in areas of maximum sun exposure (face, ears, and hands, and scalp in males). CONCLUSIONS: Misclassification of NMSC deaths in WA was minimal. The majority of NMSC deaths were due to squamous cell carcinomas; had primary sites associated with significant sun exposure; and occurred in older men.

PMID: 18386140 [PubMed - as supplied by publisher]
Atypical carcinoid (neuroendocrine carcinoma) of the gingiva: counterpart of a laryngeal tumor.

Fetched: April 4th, 2008, 9:00pm EDT

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Atypical carcinoid (neuroendocrine carcinoma) of the gingiva: counterpart of a laryngeal tumor.

Pathol Int. 2004 Feb;54(2):97-100

Authors: Abiko Y, Ogawa I, Hattori Y, Kusano K, Nishimura M, Ohuchi T, Abe U, Shibata T, Matsuda S, Takata T, Kaku T

Intraoral localization of neuroendocrine carcinoma, usually called Merkel cell carcinoma, is extremely rare. A case of neuroendocrine carcinoma that was a counterpart of laryngeal neuroendocrine carcinoma but was not a Merkel cell carcinoma, occurring at the mandibular gingiva in a 69-year-old Japanese man, is described. The tumor formed a cauliflower-like mass, measuring 20 x 20 mm, with a small area of necrosis. A computed tomography image showed metastasis in the right submandibular lymph node. Histopathologically, the tumor was composed of immature, small round cells that formed anastomosing trabecular nests. Few mitotic and no necrotic features were observed in the nests. Immunohistochemical studies showed positive staining for chromogranin, synaptophysin and neuron-specific enolase in the tumor nests. We diagnosed it as an atypical carcinoid (neuroendocrine carcinoma), a counterpart to the same type of tumor occurring in the larynx. The present case is an extremely rare case of neuroendocrine carcinoma without the feature of Merkel cell carcinoma arising from the gingiva.

PMID: 14720139 [PubMed - indexed for MEDLINE]
[Merkel cell carcinoma and sentinel lymph node dissection: nine cases report]

Fetched: March 29th, 2008, 9:00pm EDT

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[Merkel cell carcinoma and sentinel lymph node dissection: nine cases report]

G Chir. 2008 Jan-Feb;29(1-2):28-32

Authors: Migliano E, Monarca C, Tedesco M, Rizzo MI, Bucher S

Merkel cell carcinoma (MCC) is an aggressive cutaneous-neuroendocrine neoplasia with poor prognosis and high propensity for locoregional and distant metastasis. Lack of knowledge about its biological behavior, pathogenesis, and prognostic factors, complicates the prospective evaluation. Sentinel node dissection, concomitant with radical excision of the lesion, has increased in the last few years. The suitability of this technique is linked to the MCC high tendency to spread "in primis" at locoregional nodes such as other malignancies such as cutaneous melanoma. Aim of the study is the prospective evaluation of the sentinel node dissection and of the adjuvant therapies in 9 patients MCC affected. All patients, underwent evaluation and staging of the neoplasia. Diagnosis was made by excisional biopsy and histological examination. Sentinel node dissection was performed in patients without clinical locoregional metastases (8 cases). Patients with sentinel node positive for metastasis underwent radical lymphadenectomy (3 cases). One patient affected by clinically locoregional metastases had, at once, radical lymphadenectomy. Radiotherapy and/or chemotherapy as adjuvant therapy were implemented (4 cases).

PMID: 18252145 [PubMed - indexed for MEDLINE]
Merkel cell carcinoma: a review of management.

Fetched: March 28th, 2008, 9:00pm EDT

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Merkel cell carcinoma: a review of management.

Curr Opin Otolaryngol Head Neck Surg. 2008 Apr;16(2):170-4

Authors: Veness MJ, Palme CE, Morgan GJ

PURPOSE OF REVIEW: Merkel cell carcinoma is an uncommon but aggressive primary cutaneous neuroendocrine (small cell) carcinoma. The head and neck is a frequent site (50-60%) for presentation. The optimal treatment of patients with Merkel cell carcinoma remains debated with recent evidence adding support for a multimodality approach. Despite this the outcome for patients with unfavourable disease remains poor and in many series 25-50% of patients die as a direct result of Merkel cell carcinoma. RECENT FINDINGS: Wide excision (2-3 cm) of the primary lesion has been recommended, although achieving this is often impossible within the functional and cosmetic constraints of the head and neck. The well-documented responsiveness of this disease to radiotherapy and chemotherapy has strengthened the case for less radical surgery. Current best practice, as presented in recent publications, would support adjuvant wide-field radiotherapy, delivered after wide excision with negative microscopic margins, as best practice. The role of platinum-based chemotherapy remains under investigation. SUMMARY: Most patients with a Merkel cell carcinoma should be recommended wide-field adjuvant radiotherapy to encompass the primary site, in-transit tissue and first echelon lymph nodes following surgery. The benefit of adding chemotherapy is currently unproven and should be considered on an individual basis.

PMID: 18327038 [PubMed - indexed for MEDLINE]
Cytogenetics of melanoma and nonmelanoma skin cancer.

Fetched: March 20th, 2008, 9:00pm EDT

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Cytogenetics of melanoma and nonmelanoma skin cancer.

Adv Exp Med Biol. 2008;624:227-40

Authors: Carless MA, Griffiths LR

Cytogenetic analysis of melanoma and nonmelanoma skin cancers has revealed recurrent aberrations, the frequency of which is reflective of malignant potential. Highly aberrant karyotypes are seen in melanoma, squamous cell carcinoma, solar keratosis and Merkel cell carcinoma with more stable karyotypes seen in basal cell carcinoma, keratoacanthoma, Bowen's disease, dermatofibrosarcoma protuberans and cutaneous lymphomas. Some aberrations were common amongst a number of skin cancer types including rearrangements and numerical abnormalities of chromosome 1, -3p, +3q, partial or entire trisomy 6, trisomy 7, +8q, -9p, +9q, partial or entire loss of chromosome 10, -17p, +17q and partial or entire gain of chromosome 20. Combination of cytogenetic analysis with other molecular genetic techniques has enabled the identification of not only aberrant chromosomal regions, but also the genes that contribute to a malignant phenotype. This review provides a comprehensive summary of the pertinent cytogenetic aberrations associated with a variety of melanoma and nonmelanoma skin cancers.

PMID: 18348460 [PubMed - in process]
Complete spontaneous regression in Merkel cell carcinoma.

Fetched: March 12th, 2008, 9:00pm EDT

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Complete spontaneous regression in Merkel cell carcinoma.

J Plast Reconstr Aesthet Surg. 2008;61(2):165-71

Authors: Vesely MJ, Murray DJ, Neligan PC, Novak CB, Gullane PJ, Ghazarian D

Merkel cell carcinoma is a rare, aggressive, cutaneous malignancy of the elderly with a generally poor prognosis. Like all skin cancers, its incidence is rising. A few reports of spontaneous regression have been published. The case of a 67-year-old female patient who presented with a cheek Merkel cell carcinoma is described. Following biopsy it underwent complete regression with no evidence of residual tumour in the excision specimen taken seven weeks later. The current knowledge of Merkel cell carcinoma and the other cases of spontaneous regression described in the literature are reviewed.

PMID: 17382612 [PubMed - indexed for MEDLINE]
Merkel cell carcinoma of the upper extremity: case report and update.

Fetched: March 11th, 2008, 9:00pm EDT

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Merkel cell carcinoma of the upper extremity: case report and an update.

World J Surg Oncol. 2008;6:32

Authors: Papamichail M, Nikolaidis I, Nikolaidis N, Glava C, Lentzas I, Marmagkiolis K, Karassavsa K, Digalakis M

BACKGROUND: Merkel cell carcinoma is a rare but aggressive cutaneous primary small cell carcinoma. It is commonly seen in elderly affecting the head, neck, and extremities. Macroscopically may be difficult to distinguish MCC from other small cells neoplasms especially oat cell carcinoma of the lung. CASE PRESENTATION: It is presented a case report concerning a 72 years old male with a MMC on the dorsal aspect of the right wrist. The patient underwent a diagnostic excisional biopsy and after the histological confirmation of the diagnosis a second excision was performed to achieve free margins. No postoperative radiation or adjuvant chemotherapy was given and within 9 years follow up no recurrence was reported. CONCLUSION: Although most cases present as localized disease treatment should be definitive due to high rates of local or systemic recurrence. Treatment includes excision of the lesion, lymphadenectomy, postoperative radiotherapy and chemotherapy depending on the stage of the disease. Even when locoregional control is achieved close surveillance is required due to high rates of relapse.

PMID: 18328106 [PubMed - indexed for MEDLINE]
Cancer. A skin cancer virus?

Fetched: March 6th, 2008, 9:00pm EST

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Cancer. A skin cancer virus?

Science. 2008 Feb 22;319(5866):1049-50

Authors: Viscidi RP, Shah KV

PMID: 18292327 [PubMed - indexed for MEDLINE]
Expression of HuR in Merkel cell carcinoma and in normal skin.

Fetched: March 5th, 2008, 9:00pm EST

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Expression of HuR in Merkel cell carcinoma and in normal skin.

J Cutan Pathol. 2008 Jan;35(1):10-4

Authors: Koljonen V, Böhling T, Haglund C, Ristimäki A

BACKGROUND: HuR is a ubiquitously expressed member of the Elav/Hu family of mRNA-binding proteins, and its cytoplasmic expression has been recognised to participate in carcinogenesis. The aims of this study were to explore the expression pattern of HuR in primary Merkel cell carcinoma (MCC), lymph node metastases and non-neoplastic skin. METHODS: Twenty-two primary MCC samples and five lymph node metastases were evaluated for HuR expression by immunohistochemistry. The data were compared with clinical parameters. RESULTS: Nuclear and cytoplasmic HuR-staining patterns were observed. Nuclear immunoreactivity was observed in 91% of the primary tumors and in 80% of the lymph node metastases. Cytoplasm was positive in 27% of the primary tumors and in 60% of the lymph node metastases. No cytoplasmic HuR immunoreactivity was detected in non-neoplastic skin. However, moderate to strong nuclear staining was found in normal epidermis and in the epithelium of hair follicles and sebaceous glands. Expression of HuR in MCC did not associate with clinicopathological parameters. CONCLUSIONS: Primary MCCs and their lymph node metastases as well as non-neoplastic skin show nuclear expression of HuR protein. In contrast to non-neoplastic skin, a subset of MCC tumors show cytoplasmic HuR staining, which may contribute to carcinogenesis in MCC.

PMID: 18095988 [PubMed - indexed for MEDLINE]
Merkel cell cancer: update on biology and treatment.

Fetched: February 28th, 2008, 9:00pm EST

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Merkel cell cancer: update on biology and treatment.

Curr Opin Oncol. 2008 Mar;20(2):196-200

Authors: Tai P

PURPOSE OF REVIEW: This review highlights the most important developments in the biology and treatment of Merkel cell carcinoma published in the medical literature over the past year. RECENT FINDINGS: Adjuvant radiotherapy to the primary site with or without coverage of the nodal region is recommended in most older series, although a risk-adapted approach is more reasonable. Sentinel lymph node biopsy should be considered in all cases irrespective of primary size. If not feasible, prophylactic regional radiotherapy is recommended as the risk of regional relapse without nodal staging is about 45%. Adjuvant radiotherapy to nodal regions after lymphadenectomy is not studied in detail, but there is a suggestion from many series that the recurrence rate is high enough to justify its use. Recent research has revealed that adjuvant chemotherapy currently has no established role in the treatment of localized node-negative Merkel cell carcinoma. Its use in pathologically node-positive or recurrent cases requires further study. SUMMARY: Given the lack of randomized evidence and heterogeneity in published retrospective series, clinical judgment is required to assess risk factors of an individual patient to make treatment decisions.

PMID: 18300770 [PubMed - indexed for MEDLINE]
What lies beneath? Assessment of leg ulcers during acute hospital admission.

Fetched: February 22nd, 2008, 9:00pm EST

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What lies beneath? Assessment of leg ulcers during acute hospital admission.

Age Ageing. 2008 Jan;37(1):117-8

Authors: Weidmann A, Harkins K

Chronic leg ulceration is a common condition often noted in patients during an acute hospital admission. We present the case of a patient in whom thorough examination and investigation of an incidentally noted ulcer revealed a serious, previously unexpected diagnosis of disseminated Merkel cell carcinoma. This article illustrates how important it is that medical staff are aware of the different patterns of an ulcer disease and are alert to atypical appearances. Acute admission, regardless of cause, represents an opportunity for full examination of all ulcers with a view to further investigation or specialist referral if needed. Such assessment can support the often overburdened community services and ensure appropriate investigation and treatment, particularly in the context of detecting malignancy.

PMID: 17993474 [PubMed - indexed for MEDLINE]
Clinical characteristics of Merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features.

Fetched: February 19th, 2008, 9:00pm EST

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Clinical characteristics of Merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features.

J Am Acad Dermatol. 2008 Mar;58(3):375-81

Authors: Heath M, Jaimes N, Lemos B, Mostaghimi A, Wang LC, Peñas PF, Nghiem P

BACKGROUND: Merkel cell carcinoma (MCC) is an aggressive skin cancer with a mortality of 33%. Advanced disease at diagnosis is a poor prognostic factor, suggesting that earlier detection may improve outcome. No systematic analysis has been published to define the clinical features that are characteristic of MCC. OBJECTIVE: We sought to define the clinical characteristics present at diagnosis to identify features that may aid clinicians in recognizing MCC. METHODS: We conducted a cohort study of 195 patients given the diagnosis of MCC between 1980 and 2007. Data were collected prospectively in the majority of cases, and medical records were reviewed. RESULTS: An important finding was that 88% of MCCs were asymptomatic (nontender) despite rapid growth in the prior 3 months (63% of lesions) and being red or pink (56%). A majority of MCC lesions (56%) were presumed at biopsy to be benign, with a cyst/acneiform lesion being the single most common diagnosis (32%) given. The median delay from lesion appearance to biopsy was 3 months (range 1-54 months), and median tumor diameter was 1.8 cm. Similar to earlier studies, 81% of primary MCCs occurred on ultraviolet-exposed sites, and our cohort was elderly (90% >50 years), predominantly white (98%), and often profoundly immune suppressed (7.8%). An additional novel finding was that chronic lymphocytic leukemia was more than 30-fold overrepresented among patients with MCC. LIMITATIONS: The study was limited to patients seen at a tertiary care center. Complete clinical data could not be obtained on all patients. This study could not assess the specificity of the clinical characteristics of MCC. CONCLUSIONS: To our knowledge, this study is the first to define clinical features that may serve as clues in the diagnosis of MCC. The most significant features can be summarized in an acronym: AEIOU (asymptomatic/lack of tenderness, expanding rapidly, immune suppression, older than 50 years, and ultraviolet-exposed site on a person with fair skin). In our series, 89% of primary MCCs had 3 or more of these findings. Although MCC is uncommon, when present in combination, these features may indicate a concerning process that would warrant biopsy. In particular, a lesion that is red and expanding rapidly yet asymptomatic should be of concern.

PMID: 18280333 [PubMed - in process]
Merkel cell carcinoma of the skin: a retrospective study of 24 cases by the Hellenic Cooperative Oncology Group.

Fetched: February 19th, 2008, 9:00pm EST

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Merkel cell carcinoma of the skin: a retrospective study of 24 cases by the Hellenic Cooperative Oncology Group.

Oncology. 2007;72(3-4):211-8

Authors: Pectasides D, Papaxoinis G, Pectasides E, Galani H, Razi E, Katodrytis N, Fountzilas G, Economopoulos T

BACKGROUND: The purpose of this retrospective study was to present the epidemiological and clinical characteristics of 24 patients with Merkel cell carcinoma of the skin (MCC) and their response to various therapeutic modalities. METHODS: The tumor registry of the Hellenic Cooperative Oncology Group was used to identify patients with MCC diagnosed between 1986 and 2006. RESULTS: The most frequent primary sites were the extremities (50%), followed by the head (33%) and the trunk (17%). Median time of follow-up was 24 months. Sixteen patients were initially diagnosed with stage I, 5 patients with stage II, and 3 patients with stage III (metastatic) disease. Six patients with stage I disease received adjuvant chemotherapy (CT) and/or radiotherapy (RT). All patients with stage I disease treated only with surgery relapsed, whereas 33% of the patients treated with adjuvant therapy recurred. All patients with stage II disease received adjuvant treatment. Among them, 2 patients relapsed. Disease-free survival (DFS) and overall survival (OS) did not differ significantly between patients with stage I and II disease (stage I: 4-year DFS 27%, 4-year OS 56%; stage II: 4-year DFS 60%, 4-year OS 80%). Patients treated with adjuvant therapy had significantly better DFS than those treated only with surgery (p = 0.012), but OS did not differ significantly (adjuvant group: 4-year DFS 59%, 4-year OS 74%; surgery group: 4-year DFS 10%, 4-year OS 50%). Eleven patients with locally advanced or metastatic disease received CT. The response rate was 73% (complete remission 18%), median progression-free survival was 10 months and median OS was 14 months. Complete remission was achieved in 2 other cases, with the addition of RT after CT. CONCLUSIONS: MCC is an aggressive neoplasm with significant chemosensitivity and radiosensitivity, but poor outcome. The role of adjuvant treatment should be further investigated.

PMID: 18176086 [PubMed - indexed for MEDLINE]
Is the MAPK pathway involved in the aggressivity of Merkel cell carcinoma?

Fetched: February 15th, 2008, 9:00pm EST

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Is the MAPK pathway involved in the aggressivity of Merkel cell carcinoma?

Eur J Dermatol. 2007 Nov-Dec;17(6):556

Authors: Namikawa K, Nakamura Y, Takahashi T, Otsuka F

PMID: 17951154 [PubMed - indexed for MEDLINE]