Advanced Merkel cell cancer and the elderly.

BACKGROUND

Merkel cell cancer (MCC) is an uncommon neuroendocrine skin cancer occurring predominantly in elderly Caucasians. It tends to metastasize to regional lymph nodes and viscera and is sensitive to chemotherapy but recurs rapidly.

AIM: To report one such case, its response to chemotherapy and briefly review the literature.

METHODS

A 73-year-old male with a fungating primary lesion on his left knee and ulcerated inguinal lymph nodes was diagnosed with MCC and treated with chemotherapy. The two largest case series and reviews of case reports were summarised.

RESULTS

His ulcer healed after two cycles of carboplatin and etoposide with improvement in quality of life. Overall response rates of nearly 60% to chemotherapy are reported but median survival is only nine months with metastatic disease.

CONCLUSIONS

Chemotherapy should be considered for fit elderly patients with MCC who have recurrent or advanced disease.