Arch Craniofac Surg.  2019 Jun;20(3):203-206. 10.7181/acfs.2018.02236.

Two separate nodules of Merkel cell carcinoma occurring concomitantly on one cheek

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Inje University School of Medicine, Busan, Korea. jinooda@hanmail.net
  • 2Department of Pathology, Inje University School of Medicine, Busan, Korea.

Abstract

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroectodermal carcinoma arising from mechanoreceptor Merkel cells. Multiple MCCs are even rarer. We report a case of two independent MCCs simultaneously present in the cheek of a patient, which were effectively and esthetically treated using a cheek flap. Punch biopsy performed in a 60-year-old woman admitted with a chief complaint of two skin-colored hard nodules in her left cheek, accompanied by an itching sensation, was suggestive of MCC. Accordingly, we performed sentinel lymph node biopsy through the modified Blair incision under general anesthesia, in cooperation with the head and neck surgery department. The defect was covered with a cheek flap by slightly extending the existing incision following wide excision with a safety margin of 1 cm. This paper is significant in that it introduces an effective reconstruction technique that maintains function using a cheek flap for the management of this rare case. In addition, this paper is the first to classify multiple MCCs according to the time of onset. We believe that this paper presents an effective alternative reconstruction technique with sentinel node biopsy through the modified Blair incision.

Keyword

Carcinoma, Merkel cell; Cheek; Surgical flaps

MeSH Terms

Anesthesia, General
Biopsy
Carcinoma, Merkel Cell*
Cheek*
Female
Head
Humans
Mechanoreceptors
Merkel Cells
Middle Aged
Neck
Neural Plate
Pruritus
Sensation
Sentinel Lymph Node Biopsy
Surgical Flaps
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