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Merkel cell carcinoma: Very aggressive form of skin cancer

  1. Merkel cell carcinoma is a very malignant (malignant), rare form of skin cancer. The lump is usually on the face, head, or neck. The tumor grows quickly and spreads quickly to other parts of the body as well. The treatment of this type of skin cancer depends on several factors, but usually consists of surgery, chemotherapy and / or radiotherapy. Despite effective treatment, the tumor returns quickly. The prognosis is variable, but about one in three patients will die as a result. Cyril Toker first described Merkel cell carcinoma in 1972.

Epidemiology and risk factors for Merkel cell tumor

  1. The annual incidence of a Merkel cell tumor is 0.2-0.45 in 100,000 people, which is a hundred times rarer than a melanoma according to Emedicine. Merkel cell carcinoma usually develops in elderly patients (over 70s). Women are four times more likely than men to be affected by this type of skin cancer. Prolonged exposure to natural or artificial sunlight or a weak immune system (organ transplant, HIV infection, drugs, chronic leukemia

Causes very aggressive form of skin cancer

  1. The exact cause of Merkel cell carcinoma is not known. A polyomavirus is probably present in a large part of the tumors. This virus is carcinogenic and may be the cause of the aggressive metastases

Symptoms: Painless lump on face

  1. The first sign of Merkel cell carcinoma is usually a fast-growing, painless, shiny lump (tumor) on the skin. The convex tubercle is skin colored or appears in red, blue or purple. Its size is up to two centimeters (or slightly larger). Most Merkel cell tumor is on the face

Diagnosis and investigations

  1. Diagnostic examination The doctor will perform various tests to be sure of Merkel cell carcinoma. He's performing a sentinel node biopsy. In other words, it takes a piece of tissue from the sentinel node. This test determines whether the cancer has spread to the lymph nodes (lymph node metastases). For the examination, the doctor injects a dye close to the tumor. The dye then flows through the lymphatic system to the lymph nodes. The first lymph node to take up the dye is the sentinel node. The doctor removes the lymph node and looks for cancer cells under a microscope. Imaging diagnostics is also important. For example, the doctor takes an X-ray of the chest (chest X-ray) and a CT scan of the chest and abdomen to determine whether the cancer has spread to other organs. In addition, he may perform a positron emission tomography (PET scan) or an octreotide scan (neuroendocrine tumor)

Treatment: Surgery, chemotherapy and / or radiotherapy

  1. The surgeon removes the tumor along with an edge of normal skin surrounding the tumor (at least a two centimeter margin). If the tumor has spread, the surgeon also removes the lymph nodes (lymph node dissection). Radiotherapy is also useful, especially after an operation to destroy the remaining cancer cells. Sometimes radiotherapy is the only form of treatment for patients who do not want to undergo surgery. Finally, chemotherapy is useful for killing cancer cells. This is done through a vein (medical term)

Complications

  1. The treatment of Merkel cell carcinoma is not easy, because it spreads quickly despite the treatment. First, the tumor metastasizes (metastasizes) to nearby lymph nodes. Later, the cancer affects the skin, the brain

Forecast

  1. The tumor recurs in more than half of the patients within two years. When the cancer has spread to the lymph nodes, the prognosis is poor. The two-year survival is on average 50 to 70%. About one in three patients will die of the disease.



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