Merkel cell carcinoma is an extremely rare and aggressive skin tumor. Symptoms, diagnosis, treatment… An update with Professor Gaëlle QUEREUX, head of the Dermatology department at Nantes University Hospital and President of the French Society of Dermatology.
What is Merkel cell carcinoma?
Merkel’s carcinoma is a extremely rare and serious skin cancer which develops at the level of a cell present in the skin: the Merkel cell. This is a cell called a neuroendocrine cell. The prognosis for this type of cancer is quite poor. “THE recurrence rate is 30 or 40%; the 10-year survival rate is around 50%. It is such a rare tumor that we cannot obtain very precise incidence figures, but there are approximately 500 new cases per year in France. It is classically said to be 40 times less common than melanoma.“, indicates Professor Gaëlle Quereux.
What are the risk factors?
Merkel’s carcinoma mainly occurs in subjects of advanced age, the median being around 75 years. Sun exposure, especially in the case of a light phototype, also represents a significant risk factor. “This very rare skin cancer is also favored by immunosuppression (transplanted people, HIV carriers, etc.). Furthermore, the Merkel polyomavirus is found in 80-95% of cases of Merkel carcinoma. However, it is also found in healthy skin so it is not the only culprit but it is probably a cocarcinogen“, specifies the dermatologist.
What are its symptoms?
Merkel’s carcinoma takes the appearance of a papule or nodule of red, pinkish or purplish color. The preferred areas on the body are photodistributed areas, that is to say exposed to the sun regularly, therefore essentially thee face, head, neck and limbs. Typically, this type of tumor is completely painless.
What is the diagnosis?
The diagnosis of Merkel’s carcinoma is first evoked clinically, that is to say by observing the lesion. “The dermatologist suspects Merkel’s carcinoma so he analyzes it and sends it to pathology. biopsy allows the diagnosis to be made with certainty“, explains the specialist.
The treatment is based on the surgery. The tumor is removed with a safety margin and a lymph node analysis, then possibly additional rays. The presence of metastases in regional lymph nodes requires lymph node dissection, i.e. lymph node eradication. Subsequently, monitoring is established, this must take place every three to six months.
Thanks to Professor Gaëlle QUEREUX, head of the Dermatology department at Nantes University Hospital and President of the French Society of Dermatology.