Medical Dermatology

Merkel Cell Carcinoma (MCC)

Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer. Factors that contribute to an increased risk for developing MCC include older age, fair skin, weakened immune system, and extensive sun exposure. Some lesions may be associated with viral infection. Early lesions often appear harmless and may be mistaken for pimples, insect bites, and cysts. They rarely itch, hurt, or bleed. Tumors typically often feel firm and may quickly expand. While lesions may develop anywhere on the body, they are more frequently diagnosed on sun-exposed areas of the body.

Definitive diagnosis of MCC requires a biopsy. Once diagnosed, initial evaluation often includes checking to see if the cancer has spread to other parts of the body. Clinical examination, CT/ MRI/ PET-CT, and sentinel lymph node biopsies are methods to assess the extent of involvement.  Depending on what tissues the MCC involves (skin only, nearby lymph nodes, or internal organs) will determine the stage of the cancer as well as guide future treatments.

Appropriate treatment for MCC requires coordinated multi-disciplinary care including a dermatologist, medical oncologist, surgical oncologist, and radiation oncologist. Treatment often includes removing the tumor and involved lymph nodes, as well as delivering post-operative radiation. In addition, patients may benefit from recently approved immune-based therapies as well as participation in clinical trials.