Arch Plast Surg.  2019 Sep;46(5):441-448. 10.5999/aps.2019.00465.

Merkel cell carcinoma: A series of seven cases

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea. baeyc2@hanmail.net
  • 2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
  • 3Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.

Abstract

BACKGROUND
Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients.
METHODS
We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis.
RESULTS
Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a split-thickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up.
CONCLUSIONS
We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.

Keyword

Neoplasms; Carcinoma, Merkel cell; Margins of excision; Mohs surgery; Prognosis

MeSH Terms

Asian Continental Ancestry Group
Carcinoma, Merkel Cell*
Diagnosis
Follow-Up Studies
Head
Humans
Lost to Follow-Up
Lymph Nodes
Mohs Surgery
Neck
Prognosis
Radiotherapy
Radiotherapy, Adjuvant
Recurrence
Retrospective Studies
Sentinel Lymph Node Biopsy
Skin
Transplants
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