Merkel cell carcinoma of the face. Case report and review of the literature.
Merkel cell carcinoma of the skin has only recently been described. From the literature 115 cases are analysed. This carcinoma is most probably far more common than would be assumed from the few publications presently available. Between 40 to 50% of tumours are found in the head and neck area. Clinically the tumour presents as a typical bluish red firm intracutaneous nodule with the overlying skin intact, and sometimes malignant melanoma-like intracutaneous satellites. Regional lymph node metastasis is frequent and the five year survival rate, although not yet available, may well be about 50% or less. Clinical diagnosis is of paramount importance, as final diagnosis is only confirmed by electron microscopy and routine light microscopy leaves a wide range of differential diagnoses. In our case all typical characteristics are present. A cervicofacial flap which utilizes the abundant cervical skin for direct closure of the secondary defect in a U-Y manner was used to cover the primary defect. The flap is based on the preauricular area. Advantages and indications for the cervicofacial as opposed to Esser's cheek rotation flap are discussed.
D000230:Adenocarcinoma / Q000473:pathology*; D002610:Cheek; D005153:Facial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*