Serie de casos : Características del Carcinoma de Células de Merkel en pacientes del Centro de Cáncer de Piel del Hospital Italiano de Buenos Aires - Argentina. 2004-2018

Abstract

BACKGROUND: Merkel cell carcinoma is described as a malignant and aggressive neuroendocrine tumor, which represents less than 1% of non-melanoma skin tumors. It is a rare type of skin cancer that is associated with a poor prognosis and a high rate of recurrence. Despite significant advances, its pathogenesis is still poorly understood. Early diagnosis and proper management are essential to improve the survival rate. Although it affects both genders, it has male predominance. It is presented as hard, bright, reddish, and asymptomatic tumors with a certain predilection for head, neck and limbs. The treatment is surgical and in some cases, it requires adjuvant radiation therapy. An early diagnosis and appropriate handling are essential to improve the survival rate. METHODS: We conducted an observational, descriptive study ⸻case series⸻, which included 10 patients diagnosed with MCC, from the dermatology service of the Skin Cancer Center of Hospital Italiano de Buenos Aires, from January 2004 to August 2018. RESULTS: Over the course of 15 years, ten patients, 5 men and 5 women, were clinically and histopathologicallly diagnosed with Merkel Cell Carcinoma, with mean age of presentation of 83 years (range: 74-95 years). There was a high frequency (70%) of immunological alterations due to autoimmune diseases, renal-transplanted patients, and chronic lymphocytic leukemia. The therapeutic option was conventional surgery, with a margin of 3 cm, in six patients and Mohs micrographic surgery in four patients. Three patients developed local recurrence, who received adjuvant radiotherapy. CONCLUSION: The mean age of presentation was 83 years of age; there was no predominance according to sex. Most cases were localized in head and neck. Most of the patients had a concomitant immunological alteration. Most cases were resolved by conventional surgery. Recurrence rate was lower than expected (30%).