Dermatologic Manifestations of Merkel Cell Carcinoma Guidelines

Updated: Nov 07, 2018
  • Author: Christopher R Shea, MD; Chief Editor: William D James, MD  more...
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Guidelines

Guidelines Summary

New guidelines on Merkel cell carcinoma have been issued by the European Dermatology Forum, European Association of Dermato-Oncology, and European Organization of Research and Treatment of Cancer. [50] A summary is as follows:

  • Cutaneous and subcutaneous nodule clinical features do not significantly contribute to the diagnosis of MCC. Rather, histopathology and incisional or excisional biopsy results are mandatory for diagnosis.
  • Immunohistochemical staining helps clarify the diagnosis. Ultrasound of the locoregional lymph nodes and total body scanning examinations comprise the initial workup.
  • The excision margin for the primary tumor should be 1-2 cm.
  • Sentinel node biopsy is recommended for patients who do not have clinical evidence of regional lymph node involvement.
  • Radical lymphadenectomy is recommended for patients who have regional lymph node involvement.
  • Consider adjuvant radiotherapy in patients with multiple affected lymph nodes of extracapsular extension.
  • Multiple- or single-agent chemotherapy achieves high remission rates in unresectable metastatic MCC; however, responses are usually short lived.