Merkel Cell Carcinoma: Differences between Sun-Exposed and Non-Sun-Exposed Variants - A Clinical Analysis of 36 Cases

Abstract

Background: There are few studies focusing on the clinical characteristics of Merkel cell carcinoma (MCC). Objective: To retrospectively analyze the clinical features of our patients and their relationship with sun exposure. Methods: Thirty-six patients diagnosed with MCC (20 men and 16 women, mean age 72.08 years) were included in the study. Results: 21 patients developed MCC in sun-exposed skin and 15 patients in non-sun-exposed areas. MCC was >2 cm in 19 cases. Six of the 7 patients who died as a result of MCC had non-sun-exposed tumors. Only tumor size >2 cm significantly influenced survival (p = 0.033). Conclusion: Sun-exposed lesions tended to be <2 cm in diameter and were more common in men, while non-sun-exposed tumors were larger, usually occurring in women and carrying a greater likelihood of death by MCC. Non-sun-exposed tumors usually present as fast-growing, multilobar nodular lesions with a smooth shiny surface.

The use of dermatoscopy in diagnosis and therapy of nonmelanocytic skin cancer

“…The clinical picture is variable and ranges from erythematous plaques to erythematous or pink, sometimes violaceous, sharply demarcated nodules with a smooth and shiny surface. Tumor growth is usually very rapid . The most important clinical features of Merkel cell carcinoma are summarized under the acronym AEIOU: a symptomatic, rapid e xpansion, i mmunosuppression, o lder patient, located on U V‐damaged skin.…”

Recurrent Merkel cell carcinoma of the gluteal region: A case report

“…The most common location is head and neck, followed by upper extremities, lower extremities, and trunk. Marcoval et al reported that patients with non-sun-exposed MCC have worse prognosis than those with sun-exposed MCC, and have a greater chance of death by MCC (Marcoval et al, 2014). Although extremely rare, non-sun-exposed MCC is a more malignant variant of MCC.…”

“…Table 1 shows non-sun-exposed MCC from the English language literature. Marcoval et al reported that patients with non-sun-exposed MCC have worse prognosis than those with sun-exposed MCC, and have a greater chance of death by MCC (Marcoval et al, 2014).…”

Der Einsatz der Dermatoskopie in der Diagnose und Therapie von nichtmelanozytären Hautkrebsformen

“…Das klinische Erscheinungsbild ist variabel und reicht von rötlichen Plaques bis zu rötlichen oder pinkfarbenen, manchmal violetten, scharf begrenzten Knoten mit glatter, glänzender Oberfläche. Zumeist wächst der Tumor sehr rasch . Die wichtigsten klinischen Eigenschaften des Merkelzellkarzinoms werden zusammengefasst unter dem Akronym AEIOU: A symptomatisch, schnelle E xpansion, I mmunsuppression, älterer ( o lder) Patient, Lokalisation auf U V‐geschädigter Haut.…”