title: [Merkel cell carcinoma: a report of two cases].
abstract: The Authors report two cases of Merkel cell carcinoma and describe their diagnostic and therapeutic difficulties in the management of these tumours. The main therapeutic problem consists in establishing the size of the excision margins in relation to the neoplastic aggressiveness. The first case was characterised by major lymphophilia and by a tendency to relapse. Radical excision was achieved by low invasive surgery using a radioguided technique to search for microscopic disease. The radioguided technique takes the place of the intra-operative anatomo-pathological examination. After adjuvant ra- diotherapy and chemotherapy the patienthas remained in remission for three years. The second case is characterized by a rapid haematic diffusion with metastasis and exitus after one year. Radiotherapy and chemotherapy were ineffective. In this case surgery was limited to a bioptic approach since extirpative surgery would have been inappropriate. Our experience shows the wide biological variability of Merkel cell carcinoma and the importance of eclectic treatment to avoid ineffective extirpative surgery.
authors.affiliation: Unità Operativa di Chirurgia Generale, Presidio Ospedaliero di Vigevano Azienda Ospedaliera della Provincia di Pavia.
authors.forename: Cesare
authors.initials: C
authors.lastname: Rosa
authors.forename: David
authors.initials: D
authors.lastname: Cossard
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Biandrate
authors.forename: Arcangelo Pesenti
authors.initials: AP
authors.lastname: Campagnoni
authors.forename: Roberta
authors.initials: R
authors.lastname: Pandolfi
authors.forename: Marco
authors.initials: M
authors.lastname: Piccolini
authors.forename: Luigi
authors.initials: L
authors.lastname: Francia
authors.forename: Umberto
authors.initials: U
authors.lastname: Pandolfi
mesh_terms: D000368:Aged; D001003:Anal Canal; D015266:Carcinoma, Merkel Cell / Q000000981:diagnostic imaging / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006119:Groin; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods; D011868:Radioisotopes; D011877:Radionuclide Imaging; D012074:Remission Induction; D012878:Skin Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy; D013004:Somatostatin / Q000031:analogs & derivatives
chemical_list: D011868:Radioisotopes; D013004:Somatostatin; C081788:pentetreotide