CLINICAL REPORTS   

Chirurgia 2001 December;14(6):225-8

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Merkel cell tumour. Diagnostic and therapeutic approach

Coli P.

This paper reports the cases of 2 patients affected by primary neuroendocrine carcinoma of the skin (Merkel cell tumour). These cases served as the starting point for a review of this rare carcinoma. The authors emphasise that the rarity of the pathology together with its difficult diagnosis mean that there is still no standard therapeutic approach to this pathology. From the literature it emerges that surgery involving extensive and radical excision represents the accepted form of therapy. Prophylactic lymphoadenectomy is very controversial. Some authors argue in favour of its routine inclusion, while others maintain that it deprives patients of an important filter in avoiding long-term metastasis. The role played by chemio- and radiotherapy still needs to be defined. Chemotherapy is indicated for young patients and radiotherapy for locations in which surgery is more difficult (e.g. neck, face, etc.). Contrary to the data reported by early trials, Merkel cell carcinoma do not have a good prognosis and this is in part linked to recidivation and lymph node and long-term metastases, and partly to the fact that patients may also present other concomitant pathologies. The high incidence of recidivation coupled with lymphatic and hematic metastases call for a careful follow-up of operated patients.