Merkel Cell Carcinoma
Background
What is the annual incidence of Merkel cell carcinoma (MCC) in the U.S.?
~500 cases/yr of MCC in the U.S.
What is the median age of Dx for MCC?
The median age of Dx is ~74 yrs (90% >50 yrs).
What is the cell type of origin for MCC?
Neuroendocrine (dermal sensory cells)—aka trabecular or “small cell” cancer of the skin.
What is the prognosis of MCC as compared to other skin cancers?
Of skin cancers, MCC has the worst prognosis (even worse than melanoma).
What % of pts have LN involvement at Dx?
20% have LN involvement at Dx.
DMs develop in what % of pts with MCC?
50%–60% of MCC pts develop DMs.
Is MCC a radiosensitive or radioresistant tumor?
MCC is considered radiosensitive.
What demographic group does MCC affect predominantly?
Elderly whites are primarily affected by MCC.
Where do most MCCs arise anatomically?
H&N region (50%) > extremities (33%)
MCC tumors at which sites have a particularly poor prognosis?
Vulva and/or perineum MCC is associated with a particularly poor prognosis.
To what tumor type is the histologic appearance of MCC similar?
The histologic appearance of MCC is similar to small cell carcinoma of the lung.
What are the histologic subtypes of MCC?
Histologic subtypes of MCC:
Small cell
Intermediate cell
Trabecular
What histologic subtype of MCC has the best prognosis?
Trabecular MCC has the best prognosis.
What are 2 important prognostic factors in MCC?
Prognostic factors in MCC:
Thickness/DOI
LN status
Workup/Staging
What is the workup for MCC?
MCC workup: H&P, CBC, CMP, CT C/A/P, and MRI or PET for H&N primaries to assess nodal status
What imaging is required at a min for MCC staging?
CT chest/abdomen is required for staging.
Why is chest imaging paramount in the staging of MCC?
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