Cosmetic Surgery Research Today is a free monthly online journal that collates and summarizes the latest research about Cosmetic Surgery, including details on microsurgery, reconstruction, techniques, risks.

Pr33 merkel cell carcinoma: report of 19 cases and review of the literature.

Gale KL, Milsom PB, de Beer J

Whangarei Base Hospital, Northland, New Zealand.

Purpose Merkel cell carcinoma (MCC) is an aggressive primary neuroendocrine tumour of the skin. It has a propensity for dermal-lymphatic invasion, and nodal and haematogenous spread. There is no concensus regarding management. The aim of this study is to describe a provincial hospital's experience with merkel cell, and to analyse the role of therapeutic options based upon current literature. Methododology A retrospective study was undertaken using Northland Pathology database during Dec 2002-2006. Demographics, tumour morphology and behaviour together with treatment modalities were documented. Results There were nine males and 10 females with an average age of 71 years (40-94 yrs). In 13 cases the primary lesion was nodular (68%), presenting amongst various sites, mostly head/neck 37%, and lower limb 32%. Relevant associated comorbidities included; multiple SCCs (1), melanoma (1), immunosuppression (1), and CLL (1). At presentation, nine patients (47%) had regional lymphadenopathy and six patients (55%) underwent RLND. Distant metastases occured in 31%* of patients within 21 months (1-58 months). Nine patients (50%) underwent radiotherapy, and four (29%) had chemotherapy. Six patients died of MCC and one from an unrelated cause. The incidence of MCC in Northland seems to be the highest in published series, with 4.75 cases/yr, in comparison with Australian studies (up to 3.9/yr), UK studies (0.87/yr ) and USA studies (up to 4.1/yr). Conclusion MCC seems to be increasing in incidence in an aging population. Early surgical intervention, coupled with adjuvant radiotherapy may improve outcome. This aggressive tumour is likely to become more of a focus amongst the field of Plastic Surgery.

Published 10 May 2007 in ANZ J Surg, 77: A68-9.
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