The Merkel cell carcinoma.Laryngorhinootologie. 2008 Mar;87(3):205-10; quiz 211.

The Merkel cell carcinoma is a rare tumor of the subdermal tissue. Its origin are Merkel cells or the subcutaneous pluripotential stem cells. The etiology of the tumor is unknown, however, exposition to UV radiation and immunosuppression are relevant predisposing factors. Clinically, a subcutaneous rapidly growing tumor with or without enlarged lymph nodes is seen. Beside excisional biopsy and various imaging modalities, somatostatin-receptor-scintigraphy plays an important role in diagnostic. Surgical resection of the tumor combined with neck dissection followed by radiation therapy is the current therapy of choice. Different chemotherapy protocols are available for patients with distant metastasis.

Merkel cell cancer: update on biology and treatment.Curr Opin Oncol. 2008 Mar;20(2):196-200.

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.