Hauschild A, Rademacher D, Röwert J, Christophers E
Universitäts-Hautklinik Kiel.
Langenbecks Arch Chir. 1997;382(4):185-91.
Merkel cell carcinoma (MCC) is a rare neoplasm of the skin predominantly found on the head and extremities. Clinically MCC presents as a rapidly growing red or violaceous, dome-shaped, solitary tumor. The clinical and histological diagnosis of MCC remains difficult. Distinction from poorly differentiated small cell primary tumors or metastasis requires immunohistochemical analysis and-if available-electron-microscopic studies. We report on the follow-up of 10 patients with MCC treated in the past 6 years at our department. In nine patients the tumors were completely removable; in one patient with a large primary tumor of the upper lip no histologically proven complete excision could be performed. After a median follow-up of 42 months, local recurrence or lymph node involvement was observed in three patients. Two patients died following disseminated metastases, one elderly patient due to cardiac insufficiency. Our observations demonstrate that MCC is a potentially aggressive cutaneous tumor. Adequate primary surgical and adjuvant therapy as well as careful follow-up are mandatory.
默克尔细胞癌（MCC）是一种罕见的皮肤肿瘤，主要见于头部和四肢。临床上，MCC表现为迅速生长的红色或紫罗兰色、圆顶状的孤立性肿瘤。MCC的临床和组织学诊断仍然困难。与低分化小细胞原发性肿瘤或转移瘤的鉴别需要免疫组织化学分析以及（如果可行）电子显微镜研究。我们报告了过去6年在我科治疗的10例MCC患者的随访情况。9例患者的肿瘤可完全切除；1例上唇原发性大肿瘤患者无法进行组织学证实的完全切除。中位随访42个月后，3例患者出现局部复发或淋巴结受累。2例患者因广泛转移死亡，1例老年患者死于心脏功能不全。我们的观察表明，MCC是一种具有潜在侵袭性的皮肤肿瘤。必须进行充分的初次手术和辅助治疗以及仔细的随访。
