title: Advanced Merkel cell cancer and the elderly.
abstract: BACKGROUND
  Merkel cell cancer (MCC) is an uncommon neuroendocrine skin cancer occurring predominantly in elderly Caucasians. It tends to metastasize to regional lymph nodes and viscera and is sensitive to chemotherapy but recurs rapidly.
  
  
  OBJECTIVE
  To report one such case, its response to chemotherapy and briefly review the literature.
  
  
  METHODS
  A 73-year-old male with a fungating primary lesion on his left knee and ulcerated inguinal lymph nodes was diagnosed with MCC and treated with chemotherapy. The two largest case series and reviews of case reports were summarised.
  
  
  RESULTS
  His ulcer healed after two cycles of carboplatin and etoposide with improvement in quality of life. Overall response rates of nearly 60% to chemotherapy are reported but median survival is only nine months with metastatic disease.
  
  
  CONCLUSIONS
  Chemotherapy should be considered for fit elderly patients with MCC who have recurrent or advanced disease.
authors.affiliation: Department of Medical Oncology, Cork University Hospital, Wilton, Cork. brianbird@eircom.net
authors.forename: B R
authors.initials: BR
authors.lastname: Bird
authors.forename: D
authors.initials: D
authors.lastname: Myers
authors.forename: S M
authors.initials: SM
authors.lastname: Ryan
authors.forename: G
authors.initials: G
authors.lastname: Wyse
authors.forename: S T
authors.initials: ST
authors.lastname: O'Sullivan
authors.forename: O S
authors.initials: OS
authors.lastname: Breathnach
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D015266:Carcinoma, Merkel Cell / Q000175:diagnosis / Q000188:drug therapy*; D018450:Disease Progression; D005047:Etoposide / Q000627:therapeutic use*; D006119:Groin / Q000473:pathology; D006801:Humans; D007717:Knee / Q000473:pathology; D008297:Male; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D005047:Etoposide; D016190:Carboplatin