Merkel cell carcinoma

Merkel Cell Carcinoma: A Rare and Aggressive Form of Skin Cancer

Merkel cell carcinoma (MCC) is a rare but aggressive type of skin cancer that can be life-threatening [1]. It affects the outer layer of the skin, or epidermis [2].

Causes and Risk Factors

MCC starts in the Merkel cells, which are usually found in the top layer of the skin (the epidermis) [4][5]. These cells are responsible for transmitting sensory information from the skin to the nervous system. When Merkel cells start to grow out of control, they can form a tumor.

Symptoms and Characteristics

MCC typically develops on sun-exposed skin areas such as the head, neck, arms, and is characterized by a painless, firm bump that can be red-purple or skin-colored [6]. The condition is most common among fair-skinned people of European ancestry, but can also affect other populations.

Treatment Options

Treatment for stage I and stage II MCC may include surgery to remove the tumor, such as wide local excision with or without lymph node dissection [2].

Prevalence and Prognosis

MCC is a very rare disease in which malignant cells form in the skin [8]. The condition has a high risk of returning (recurring) and spreading (metastasizing), often within a short period.

References: [1] - Merkel cell carcinoma is a rare but aggressive type of skin cancer that can be life-threatening. [2] - Treatment of stage I and stage II Merkel cell carcinoma may include the following: Surgery to remove the tumor, such as wide local excision with ... [4] - Merkel cell carcinoma (MCC) is a rare type of skin cancer. It starts in the Merkel cells, which are usually in the top layer of the skin (the epidermis). [5] - Merkel cell carcinoma (MCC) is a rare type of skin cancer. It starts when cells in the skin called Merkel cells start to grow out of control. [6] - MCC usually develops on sun-exposed skin (e.g., head, neck, arms) as a painless, firm bump that can be red-purple or skin-colored. [8] - Merkel cell carcinoma is a very rare disease in which malignant (cancer) cells form in the skin.

Merkel Cell Carcinoma Signs and Symptoms

Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer that can appear as a painless lump or bump on the skin. The signs and symptoms of MCC are often similar to those of other skin conditions, making it essential to be aware of the typical characteristics of this disease.

Common Signs and Symptoms:

• A single, fast-growing, painless nodule (tumor) on the skin [1]
• The nodule may be skin-colored or may have a reddish-purple color [2][5]
• It often appears as a shiny bump that usually doesn't hurt [3][7]
• MCC typically develops on sun-exposed skin areas such as the head, neck, arms, and face [4][6]

Other Characteristics:

• The lesion may resemble a cyst, pimple, or mole [7]
• It can be firm to the touch and raised, with a rounded shape like a dome [9]
• MCC often expands rapidly, and in some cases, it may not be painful or tender [8]

It's essential to note that these signs and symptoms can vary from person to person, and not everyone will experience all of them. If you suspect you have Merkel cell carcinoma, consult a healthcare professional for proper diagnosis and treatment.

References: [1] - The first sign of Merkel cell carcinoma is usually a fast-growing, painless nodule (tumor) on your skin. [2] - The nodule may be skin-colored or may ... [3] - It often first appears as a single pink, red, or purple shiny bump that usually doesn't hurt. [4] - MCC usually develops on sun-exposed skin (e.g., head, neck, arms) as a painless, firm bump that can be red-purple or skin-colored. [5] - The first Merkel cell carcinoma symptom is a painless red, purple, or pink bump on the skin. [6] - Merkel cell carcinoma usually appears as a single painless lump on sun-exposed skin. [7] - Early warning signs of Merkel cell carcinoma. MCC often appears as a painless, firm, shiny bump or nodule on the skin. [8] - A: ASYMPTOMATIC lesion, not painful or tender · E: Lesion is EXPANDING rapidly · I: You are IMMUNOsuppressed · O: You are OLDER than 50 · U: The lesion appears on ... [9] - What are the symptoms of Merkel cell carcinoma? · Reddish-purple color (sometimes pinkish or bluish) · Raised and rounded, like a dome · Hard to the touch ...

Diagnostic Tests for Merkel Cell Carcinoma

Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer that requires prompt diagnosis and treatment. The following diagnostic tests are commonly used to diagnose MCC:

• Physical Exam: A thorough physical examination by a doctor can help identify unusual moles, freckles, pigmented spots, and other growths on the skin that may indicate MCC [1].
• Skin Biopsy: A skin biopsy is the most definitive test for diagnosing MCC. During this procedure, a small tissue sample is removed from the affected area and examined under a microscope for cancer cells [4][14].
• Immunohistochemistry (IHC): IHC is a special lab test that looks for certain proteins on the cancer cells to confirm the diagnosis of MCC [1].
• Sentinel Lymph Node Biopsy (SLNB): SLNB may be recommended by doctors if MCC is diagnosed, to check if the cancer has spread to the lymph nodes [3][10].

Additional Tests

Other tests that may be used to diagnose and stage MCC include:

• Computed Tomography (CT) Scan: A CT scan may be ordered to determine if the cancer has spread to other parts of the body [13].
• Fine Needle Aspiration Biopsy: This procedure involves using a fine needle to remove a sample of tissue from the affected area for examination under a microscope [4].
• Shave Biopsy and Punch Biopsy: These procedures involve removing a small sample of tissue from the affected area using a razor blade or a special round instrument, respectively [8][9].

It's essential to note that early diagnosis and treatment can improve the prognosis for MCC patients. If you have any concerns about your skin health or suspect symptoms of MCC, consult with a healthcare professional promptly.

References:

[1] Context 1 [3] Context 3 [4] Context 2 & 8 [10] Context 10 [13] Context 13 [14] Context 14

Treatment Options for Merkel Cell Carcinoma

Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer that requires prompt treatment. While there are various treatment options available, the most effective approach often involves a combination of therapies.

Chemotherapy

Chemotherapy has been traditionally used to treat MCC, particularly in advanced stages. However, its efficacy in distant metastatic MCC patients is unclear [7]. Commonly used chemotherapy drugs for MCC include:

• Cisplatin
• Carboplatin
• Etoposide
• Topotecan

These chemotherapeutic agents can be administered through a vein (IV) or taken as pills [5].

Immunotherapy

In recent years, immunotherapy has emerged as the most promising treatment approach for MCC. This type of therapy uses medications to stimulate the immune system to recognize and attack cancer cells. Some examples of immunotherapy drugs used to treat MCC include:

• Pembrolizumab (Keytruda)
• Retifanlimab (Zynyz)
• Nivolumab (Opdivo)

These PD-1 inhibitors can be given as an infusion into a vein (IV) [2].

Other Treatment Options

In addition to chemotherapy and immunotherapy, other treatment options for MCC may include:

• Surgery: This is often the primary treatment approach for early-stage MCC.
• Radiation therapy: May be used in combination with surgery or as a standalone treatment.

It's essential to note that each patient's situation is unique, and the most effective treatment plan will depend on various factors, including the stage of cancer, overall health, and personal preferences [9].

Recent Developments

In 2023, the FDA granted accelerated approval to retifanlimab-dlwr, a PD-1 inhibitor, as a treatment for adults with metastatic or recurrent locally advanced MCC [8]. This development highlights the ongoing efforts to improve treatment options for patients with this rare and aggressive form of skin cancer.

References:

[1] Dec 6, 2022 — Chemotherapy uses drugs to kill the cancer cells. Chemotherapy drugs can be administered through a vein in your arm or taken as a pill or both. [2] May 30, 2024 — Pembrolizumab (Keytruda), retifanlimab (Zynyz), and nivolumab (Opdivo), which block PD-1. These drugs are given as an infusion into a vein (IV), ... [3] Pembrolizumab was recently listed as a treatment option for patients with metastatic MCC on the NCCN guidelines. This drug is approved by the US FDA for ... [4] Apr 13, 2023 — Drugs Approved for Merkel Cell Carcinoma · Avelumab · Bavencio (Avelumab) · Keytruda (Pembrolizumab) · Pembrolizumab · Retifanlimab-dlwr · Zynyz ( ... [5] May 30, 2024 — Which chemo drugs are used to treat Merkel cell cancer (MCC)? · Cisplatin · Carboplatin · Etoposide · Topotecan. [6] Immunotherapy may be an effective treatment for some patients with late-stage Merkel cell carcinoma. Read this page from Moffitt to learn more. [7] Cytotoxic chemotherapy is commonly used to treat advanced Merkel cell carcinoma (MCC). However, its efficacy in distant metastatic MCC patients is unclear, in ... [8] In 2023, the FDA granted accelerated approval to retifanlimab-dlwr, also a PD-1 inhibitor, as a treatment for adults with metastatic or recurrent locally ... [9] A variety of drugs can be used to treat Merkel cell carcinoma. Chemotherapy was traditionally used, but in recent years, immunotherapy has emerged as the most ...

Differential Diagnosis of Merkel Cell Carcinoma

Merkel cell carcinoma (MCC) is a rare and aggressive type of skin cancer that can be life-threatening. When diagnosing MCC, it's essential to consider its differential diagnosis, which includes various benign and malignant conditions.

Common Differential Diagnoses:

• Basal Cell Carcinoma: A common type of skin cancer that can mimic the appearance of MCC [7].
• Small Cell Carcinoma of the Lung: These tumors may be morphologically identical to MCC, making differential diagnosis challenging [2].
• Benign Skin Lesions: Such as chalazion, lipoma, dermatofibroma, cysts, or vascular lesions, which can also present with similar symptoms [4].
• Cutaneous Squamous Cell Carcinoma: A type of skin cancer that can be confused with MCC due to its similar histopathological features [6].

Other Differential Diagnoses:

• Adnexal Tumors: Such as anaplastic sweat gland tumor, annulare and pyogenic granuloma, which can also present with similar symptoms [1].
• Small Blue Round Cell Tumors: A group of tumors that can include MCC, but also other types of cancers like Ewing's sarcoma or neuroblastoma.

Key Points:

• The differential diagnosis of MCC is broad and includes various benign and malignant conditions.
• Accurate diagnosis requires careful consideration of clinical presentation, histopathological features, and immunohistochemical staining.
• A thorough understanding of the differential diagnoses is essential for effective management and treatment of MCC.

References:

[1] Mar 24, 2023 — Differential Diagnoses · Adnexal Tumors [2] Differential diagnosis of Merkel cell carcinoma ... [3] by SOM Siqueira · 2023 · Cited by 14 — [4] by D Huang — Differential diagnosis. [5] by JC Becker · 2017 · Cited by 577 — [6] Mar 27, 2023 — The nonspecific characteristics of Merkel cell carcinoma (MCC) lead to a lengthy differential diagnosis that includes basal cell carcinoma, ... [7] Jun 29, 2022 — Merkel cell carcinoma ...