title: Unusual ulcerated Merkel cell carcinoma of the skin: report of a case.
abstract: Merkel cell carcinoma is an aggressive skin cancer, usually related to a severe prognosis. Treatment consists of wide surgical excision, adjuvant radiotherapy and/or polychemotherapy, but local-regional and distant relapses are common. Detection of histopathological and biological factors may select subgroups of patients suitable for different treatments. Herein we report the case of a patient treated for a wide bleeding and ulcerated Merkel cell carcinoma. Ulceration represents an uncommon feature because the tumor usually spreads from the dermis into subcutaneous fat, so it may be added to poor prognostic indicators. After surgical excision and postoperative radiotherapy, the patient recurred at regional nodes. Axillary lymphadenectomy was followed by courses of polychemotherapy. We obtained a satisfactory survival (31 months) by timing these different therapeutic possibilities.
authors.affiliation: 3rd Department of Surgery, Hospital S. Giovanni, Addolorata, Rome, Italy. giorgiolucandri@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lucandri
authors.forename: Paolo
authors.initials: P
authors.lastname: Mazzocchi
authors.forename: Bruno
authors.initials: B
authors.lastname: Bascone
authors.forename: Marco
authors.initials: M
authors.lastname: Giordano
authors.forename: Massimo
authors.initials: M
authors.lastname: Castaldi
authors.forename: Alfredo
authors.initials: A
authors.lastname: Lazzarini
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Carotenuto
mesh_terms: D015266:Carcinoma, Merkel Cell / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D012878:Skin Neoplasms / Q000150:complications / Q000473:pathology*; D012883:Skin Ulcer / Q000209:etiology* / Q000473:pathology