Merkell Cell Carcinoma

What is Merkel cell carcinoma?

Merkel cell carcinoma is a rare form of skin cancer which begins within neuroendocrine cells of the skin. It is a cancer in that it has the ability to spread to lymph nodes and traveled to the bloodstream to other areas of the body.

How is Merkel cell carcinoma diagnosed?

Merkel cell carcinoma of the skin usually forms a painless raised lump on the skin which can be reddish in color. Often the tumors can be rapidly rolling but occasionally they are slow growing and thought to be noncancerous lumps until there is a change in their appearance. Biopsy of the nodule with examination under the microscope is the only way to diagnose Merkel cell carcinoma.

How is Merkel cell carcinoma treated?

Surgical removal of the tumor with a wide clear margin of surrounding normal skin is the optimal treatment for Merkel cell carcinoma. We always take into account the location of the Merkel cell carcinoma and avoid unnecessary side effects or disfigurement resulting from the tumor removal. Merkel cell carcinoma can spread to lymph nodes and often those lymph nodes cannot be felt on exam or seen on radiology studies. For this reason, we often perform a sentinel lymph node biopsy at the time of Merkel cell carcinoma excision. A sentinel lymph node biopsy involves identifying the first draining lymph node from the tumor and removing that lymph node through a tiny incision. The lymph node is evaluated under the microscope and if there is Merkel cell carcinoma present in the lymph node, additional lymph nodes may need to be removed at a later date.

Occasionally we will use additional treatment in the form of radiation therapy after surgery to help prevent recurrence of Merkel cell carcinoma. When Merkel cell carcinoma has spread beyond our ability to remove it surgically, immunotherapy or targeted medications can be used to limit the growth of the tumor.