title: Incidence of Merkel cell carcinoma in renal transplant recipients.
abstract: BACKGROUND
  The risk factors for Merkel cell carcinoma (MCC), a rare type of skin cancer, are poorly understood. Some evidence suggests that MCC is more common in individuals with abnormal immune function resulting from viral infection, autoimmune disease or organ trans- plantation.
  
  
  METHODS
  The national Renal Transplant Registry and the Finnish Cancer Registry data were searched for recipients of a renal transplant who were diagnosed with MCC. The MCC diagnoses were confirmed using immunohistochemistry.
  
  
  RESULTS
  Three cases of MCC were detected among 4200 individuals who underwent renal transplantation from 1967 to 2005 [expected number 0.05, standardized incidence ratio (SIR) 66, 95% CI 14-194, P <0.001]. The latency period between the transplant and detection of MCC ranged from 6 to 19 years. In all three cases, the cause of transplantation was an autoimmune disease. All three died from aggressive MCC with a survival time ranging from 0.5 to 2.1 years.
  
  
  CONCLUSIONS
  The results indicate that the risk of MCC is greatly increased among subjects who have undergone renal transplantation. The course of the disease appears aggressive in this patient population. The physicians who treat recipients of a kidney transplant should be aware of the substantially increased risk of MCC.
authors: Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland. virve.koljonen@hus.fi
authors: Virve
authors: V
authors: Koljonen
authors: Heli
authors: H
authors: Kukko
authors: Erkki
authors: E
authors: Tukiainen
authors: Tom
authors: T
authors: Böhling
authors: Risto
authors: R
authors: Sankila
authors: Eero
authors: E
authors: Pukkala
authors: Harri
authors: H
authors: Sihto
authors: Heikki
authors: H
authors: Joensuu
authors: Lauri
authors: L
authors: Kyllönen
authors: Heikki
authors: H
authors: Mäkisalo
mesh_terms: D000328:Adult; D000368:Aged; D015266:Carcinoma, Merkel Cell / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000453:epidemiology*