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Cancer Genetics

Merkel Cell Tumors

04/01/1999

Question:

My friend has been diagnosed with having a Merkel Cell tumor. What is the root cause and what are the options and is it curable.

Answer:

Merkel cells or Merkel disks are specialized nerve endings in the deeper layers of the skin which serve as touch receptors.

According to DeVita`s Cancer: Principles & Practice of Oncology, a cancer or carcinoma which arises from these cells is uncommon and highly malignant. The cancer occurs mostly in white, elderly persons, with equal incidence in men and women. It is more likely to occur in the sun-exposed areas of the head and neck but may occur elsewhere also.

The recommended treatment is surgical removal of the tumor and prophylactic removal of the lymph nodes in the region. Postoperative radiation therapy to the local site and lymph nodes is helpful. Chemotherapy is considered effective in some reports.

The long term outlook differs between men and women. Men have a 3-year survival rate of 35.6% while women have a 67.6% rate. The three reported instances of spontaneous regression occurred in women.

Medical references which may be helpful include:

Meland NB, Jackson IT (1986): Merkel cell tumor diagnosis, prognosis, and management. Plastic Reconstructive Surgery 77:632-638.

Shaw JHF, Rumball E (1991): Merkel cell tumor: clinical behavior and treatment. British Journal of Surgery 78:138-142.

Crown J, Lipzstein R, Cohen S, et al (1991): Chemotherapy of metastatic Merkel cell cancer. Cancer Investigation 9:129-132.

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Response by:

Heather L Hampel, MS, CGC Heather L Hampel, MS, CGC
Cancer Genetic Counselor
College of Medicine
The Ohio State University

Judith A Westman, MD Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University