Cirugia y cirujanos · 2020
Merkel cell carcinoma: Clinical and anatomopathological features, management and survival in our centre.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
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Francés-Monasterio Mónica, García-Minarro Ángela, Paredes-Pérez Ana B, García-Duque Orlando
Аннотация
OBJECTIVE: To summarize the features of the Merkel cell carcinoma (MCC) and to sistematyze its diagnosis and therapeutic management.
METHOD: We performed a literature review in PubMed, obtaining a total of 3,308 articles, selecting 10 for its complete reading and 22 for the reading of the summary according to the content.
RESULTS: In none of our patients, the MCC was the first suspected diagnosis. The treatment consisted in surgical excision with tumor free margins and lymphadenectomy. We offered ad-juvant RT which they rejected. They remain disease-free at the present time.
CONCLUSIONS: MCC is a rare and aggressive disease which presents as a fast-growing solitary asymptomatic erythematous nodule in those areas of skin which are exposed to sunlight in elderly patients. The main risk factors include radiative ultraviolet, immunosuppression and merkel cell polyomavirus. Surgery is the main loco-regional treatment. Lymph node metastases in the course of the disease is one of the main prognostic factors. If there are no adenopaties, sentinel lymph node biopsy must be done; if there are adenopaties or a positive biopsy, lymphadenectomy is indicated. Radiotherapy is indicated in all stages of disease since it has shown to improve loco-regional control. In distant metastatic disease, immunotherapy and participating in clinical trials are the first choice.
METHOD: We performed a literature review in PubMed, obtaining a total of 3,308 articles, selecting 10 for its complete reading and 22 for the reading of the summary according to the content.
RESULTS: In none of our patients, the MCC was the first suspected diagnosis. The treatment consisted in surgical excision with tumor free margins and lymphadenectomy. We offered ad-juvant RT which they rejected. They remain disease-free at the present time.
CONCLUSIONS: MCC is a rare and aggressive disease which presents as a fast-growing solitary asymptomatic erythematous nodule in those areas of skin which are exposed to sunlight in elderly patients. The main risk factors include radiative ultraviolet, immunosuppression and merkel cell polyomavirus. Surgery is the main loco-regional treatment. Lymph node metastases in the course of the disease is one of the main prognostic factors. If there are no adenopaties, sentinel lymph node biopsy must be done; if there are adenopaties or a positive biopsy, lymphadenectomy is indicated. Radiotherapy is indicated in all stages of disease since it has shown to improve loco-regional control. In distant metastatic disease, immunotherapy and participating in clinical trials are the first choice.