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Merkel Cell Carcinoma: Rare but Aggressive Skin Cancer
Key Facts
- Origin: Merkel cells (mechanoreceptors) in basal epidermis.
- Incidence: ~3,000 cases/year US; rising.
- Risk Factors: UV exposure, immunosuppression, age >50, fair skin, Merkel cell polyomavirus (MCPyV) in ~80%.
- Presentation: Painless, firm, rapidly growing red/purple nodule on sun-exposed skin (head/neck/extremities).
- Aggressiveness: High metastatic potential (lymph nodes, lungs, liver, bone, brain).
- Staging: TNM; sentinel node biopsy crucial.
- Treatment: Wide excision + sentinel node biopsy → adjuvant radiation to primary/regional nodes → systemic therapy (immunotherapy: pembrolizumab, avelumab) for advanced disease.
- Prognosis: 5-yr OS: localized ~75%, regional ~50%, distant ~20%.
Early detection and multidisciplinary care are vital.
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