Migliano E, Monarca C, Tedesco M, Rizzo M I, Bucher S
IRCCS San Gallicano Istituto IFO Roma, Dipartimento di Chirurgia Plastica Ricostruttiva, Italy.
G Chir. 2008 Jan-Feb;29(1-2):28-32.
Merkel cell carcinoma (MCC) is an aggressive cutaneous-neuroendocrine neoplasia with poor prognosis and high propensity for locoregional and distant metastasis. Lack of knowledge about its biological behavior, pathogenesis, and prognostic factors, complicates the prospective evaluation. Sentinel node dissection, concomitant with radical excision of the lesion, has increased in the last few years. The suitability of this technique is linked to the MCC high tendency to spread "in primis" at locoregional nodes such as other malignancies such as cutaneous melanoma. Aim of the study is the prospective evaluation of the sentinel node dissection and of the adjuvant therapies in 9 patients MCC affected. All patients, underwent evaluation and staging of the neoplasia. Diagnosis was made by excisional biopsy and histological examination. Sentinel node dissection was performed in patients without clinical locoregional metastases (8 cases). Patients with sentinel node positive for metastasis underwent radical lymphadenectomy (3 cases). One patient affected by clinically locoregional metastases had, at once, radical lymphadenectomy. Radiotherapy and/or chemotherapy as adjuvant therapy were implemented (4 cases).
默克尔细胞癌(MCC)是一种侵袭性皮肤神经内分泌肿瘤,预后较差,局部区域和远处转移倾向高。由于对其生物学行为、发病机制和预后因素缺乏了解,使得前瞻性评估变得复杂。在过去几年中,前哨淋巴结清扫术与病变的根治性切除术同时进行的情况有所增加。该技术的适用性与MCC在局部区域淋巴结如皮肤黑色素瘤等其他恶性肿瘤中“首先”扩散的高倾向有关。本研究的目的是对9例MCC患者的前哨淋巴结清扫术和辅助治疗进行前瞻性评估。所有患者均接受了肿瘤的评估和分期。通过切除活检和组织学检查进行诊断。对无临床局部区域转移的患者进行了前哨淋巴结清扫术(8例)。前哨淋巴结转移阳性的患者接受了根治性淋巴结切除术(3例)。1例临床局部区域转移患者立即接受了根治性淋巴结切除术。实施了放疗和/或化疗作为辅助治疗(4例)。