Merkel cell carcinoma
Other Names for this Disease
- Merkel cell cancer
- Merkle tumors
- Carcinoma, merkel cell
- Cutaneous neuroendocrine carcinoma
Your QuestionWhen staging Merkel cell carcinoma with sentinel lymph node biopsy, is the use of a tracer as effective as blue dye for identifying the sentinel lymph node? What is the role of Mohs surgery for treating Merkel cell carcinoma?
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Successful treatment of Merkel cell carcinoma depends on the removal of all cancerous cells, including the main cancer and any cancerous cells that may have spread to nearby lymph nodes or to more distant parts of the body. To increase the chance of removing all cancerous cells, a process known as staging is used to determine the extent of the cancer in the body. A sentinel lymph node biopsy, in which the lymph nodes are first "mapped" using a radioactive material or blue dye in an attempt to identify the lymph node most likely to contain cancerous cells, may be an important step in staging Merkel cell carcinomas, particularly those that occur in the head and neck. This lymph node, known as the sentinel lymph node, is then surgically removed and examined for the presence of cancer. In Merkel cell carcinoma, radioactive material has been shown to be more effective than blue dye alone for identifying sentinel lymph nodes.
Last updated: 5/28/2011
Treatment for Merkel cell carcinoma typically begins with surgery to remove the cancer. The first standard surgical procedure is a wide local excision, in which the cancer and some surrounding healthy tissue are removed. A newer surgical technique, known as Mohs surgery, has been shown to be as effective as wide local excision in treating Merkel cell carcinoma. Both techniques are endorsed by the National Comprehensive Cancer Network as acceptable surgical treatments.
Last updated: 5/28/2011
- National Cancer Institute. General Information about Merkel Cell Carcinoma. Merkel Cell Carcinoma Treatment. 2011; http://www.cancer.gov/cancertopics/pdq/treatment/merkelcell/healthprofessional. Accessed 5/22/2011.
- Alex JC. The application of sentinel lymph node radiolocalization to solid tumors of the head and neck: a 10-year experience. Laryngoscope. 2004; 114:2-19. http://www.ncbi.nlm.nih.gov/pubmed/14709988. Accessed 5/23/2011.
- O'Connor WJ, Roenigk RK, Brodland DG. Merkel cell carcinoma. Comparison of Mohs micrographic surgery and wide excision in eighty-six patients. Dermatologic Surgery. 1997; 23:929-933. http://www.ncbi.nlm.nih.gov/pubmed?term=9357504. Accessed 5/22/2011.
- National Comprehensive Cancer Network. Merkel cell carcinoma. NCCN Clinical Practice Guidelines in Oncology. 2011; http://www.nccn.org/professionals/physician_gls/pdf/mcc.pdf. Accessed 5/22/2011.