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Merkle Cell Carcinoma

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About Merkle Cell Carcinoma

Merkel cell carcinoma is an aggressive cancer of the skin that occurs in the elderly and primarily in sun exposed areas.  The classic Merkel cell carcinoma is characterized by aggressive local behavior and intradermal metastases. The metastases can appear several centimeters from the area of the original tumor.  The diagnosis is made with a simple biopsy. Workup of Merkel cell carcinoma requires imaging with MRI and CT/PET scans and possible sentinel lymph node biopsy.


Treatment of Merkel cell carcinoma inlcudes wide local resection with 1 cm margins.  In larger tumors even wider margins such as 2 cm are indicated.  Postoperative radiation therapy is frequently required in Merkel cell carcinomas.  Merkel cell carcinomas are uniquely radiosensitive and can also be treated primarily with radiation therapy.  However, the optimal treatment is surgical resection with postoperative radiation therapy.  The hallmark of Merkel cell carcinoma is recurrence several centimeters away from primary treatment site in multiple clusters of intradermal spread.

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