What is Merkel cell carcinoma?
Merkel cell carcinoma is a rare type of skin cancer that develops from the Merkel cells located in the top layer of the skin. These cells are situated near the nerve endings that are involved in the sense of touch.
Merkel cell carcinoma is more common in individuals over 50 years old and tends to recur. This type of skin cancer is categorized into different stages based on the size and spread of the tumour:
- Stage 0: Abnormal cells are present on the upper layer of the skin.
- Stage I: Tumour size is 2 cm or less.
- Stage II: Tumour size is greater than 2 cm and has spread to nearby tissues such as muscles and bones.
- Stage III:
- IIIA: The tumour may have spread to nearby tissues or lymph nodes, but the primary tumour may not be detectable.
- IIIB: Tumour has spread to lymph nodes or lymph vessels.
- Stage IV: Tumour has spread to distant organs such as the liver, lungs, and brain.
Disease Causes
The exact cause of this condition is not well-known. However, certain hereditary and genetic mutations, along with specific risk factors such as excessive exposure to sunlight, use of tanning beds, a history of other cancers, and a compromised immune system due to factors like HIV or organ transplantation, may contribute to its development.
Signs and symptoms
The patient may suffer from the following signs and symptoms. These are
- Fat growing lump or mass with no pain
- A lump or mass is usually hard, and firm and is of red or violet
Diagnosis
The following diagnostic techniques and procedures can be utilized for making a diagnosis. These include:
- Physical examination: Physical examination of the skin is usually performed to assess any abnormal mass on the skin and lymph nodes
- Imaging techniques such as ultrasonography, CT scan, MRI, and X-ray are used to detect the site, size, and extent of the tumour.
- CT Scan: A CT scan is used to check whether tumours have spread to other parts of the body.
- Core Needle biopsy: During a biopsy, a small tissue sample is taken for laboratory testing to check for cancer. A medical professional may cut or remove a portion of the suspicious tissue.
- Fine-needle aspiration cytology
- Tumour Markers
- Immunohistochemistry: This test is used to detect the cancer cell markers
Treatment
The main treatment involves surgically removing the tumour tissues with clear margins (healthy tissue surrounding the tumour). Surgery may also be performed if the tumour has spread to nearby lymph nodes. Other treatment options include chemotherapy, radiation therapy, and immunotherapy.
In radiation therapy, high-energy X-rays are used to kill cancer cells, often in combination with surgical treatment. Chemotherapy uses drugs to stop cancer cells from growing, while immunotherapy boosts the body’s immunity to attack cancer cells.
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