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Merkel Cell Carcinoma

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John Han-Chih Chang, MD and Kenneth Blank, MD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
I need a question answered. I have a friend whose husband has skin cancer. The doctors have mentioned something about Merkel Cells, which apparently are rare. Can you tell me something about these cells?

I am curious as to what kind of cells these are, and what they mean if they are in the body.  
Thank you for your time.
B.N.

John Han-Chih Chang, MD and Kenneth Blank, MD, OncoLink Editorial Assistants, respond:

Thank you for your interest and question.

Fortunately, Merkel cell carcinoma of the skin is a very rare skin cancer. However, unfortunately for your friend, it is a very aggressive cancer. It usually occurs in the 6^th to 8^th decade of life. It can initially be misdiagnosed as other types of skin cancer. Normal Merkel cells are located around hair follicles and function to sense tactile stimulus on the skin. Merkel cells are in the basal layer of the epidermis and contain membrane-bound neuro-secretory granules. Lesions from Merkel cell carcinoma are raised diffuse red-pink nodules. Most are found on the head and neck or extremities.

The aggressive aspect of this tumor stems from the fact that nearly half of these tumors have spread to lymph nodes or distantly at the time of diagnosis. The treatment requires surgery to remove the primary tumor followed by radiation therapy to the surgical site and regional lymph nodes. Chemotherapy has now been used, but its utility is not completely understood in this disease. The duration of the effect of chemotherapy appears to be short lived.