Single center experiences in merkel cell carcinoma and unprecedented presentation

Abstract

Aim: Merkel cell carcinoma (MCC) is a rare skin tumor with an aggressive course. If there is no distant metastasis in its treatment, excision with negative surgical margins is the primary method. Since it is usually detected in incidental postoperative pathology reports, negative surgical margins must be observed during the removal of lesions on the skin. Material and Methods: In our study, we analyzed eleven patients diagnosed with MCC in our hospital between January 2010 and January 2020. Patients with perineural or vascular invasion, borderline microscopic positive findings, residual disease, and/or regional lymph node involvement among patients with tumors larger than 1.5 cm in pathology reports were referred to adjuvant treatment. Results: The tumors were most frequently located in the thigh (25%), head-neck (25%), forearm (16.6%). inguinal (16.6%), and gluteal region (16.6%), respectively. The patients were followed up for an average of 38 months postoperatively (11-62 months). Complete cure was achieved in five (45.4%) of the cases. The average survival duration was 36 months (11-62 months). Recurrence was observed in two of our cases. Despite metastases occurring at different times in different abdominal organs abdomen, the surveillance was longer than expected, with an excellent response to multidisciplinary treatments. Discussion: The features of the lesion should be carefully examined in the preoperative period. If in doubt, a sentinel biopsy should be performed during surgery by performing systemic screening. A multidisciplinary approach should be preferred in metastatic lesions. If intra-abdominal metastases are resectable, surgical treatment may prolong the surveillance.