title: Ileocaecal recurrence of Merkel cell carcinoma of the skin: a case report.
abstract: BACKGROUND
  Merkel cell carcinoma is an uncommon skin malignancy that has a high propensity for metastatic spread. A systematic literature search identified 17 cases describing metastasis to the gastrointestinal tract, with 7 cases involving the small or large bowel. To the best of our knowledge, this is the only case described of Merkel cell carcinoma metastasising to the ileocaecal valve.
  
  
  METHODS
  We present a 74-year-old Filipino woman diagnosed with Merkel cell carcinoma of the skin with regional node involvement. Following excision and radiotherapy, the tumour recurred with metastasis to the ileocaecal valve. The patient died 28 months after the initial diagnosis.
  
  
  CONCLUSIONS
  The prognosis of metastatic Merkel cell carcinoma is poor. Currently the optimal management for metastatic disease is unclear and lacks a firm evidence base due to the small number of cases reported.
authors.affiliation: Academic Surgical Unit, St Mary's Hospital, Imperial College Healthcare, Praed Street, London W2 1NY, UK. michelle.cm.cheung@gmail.com.
authors.forename: Michelle
authors.initials: M
authors.lastname: Cheung
authors.forename: Henry
authors.initials: H
authors.lastname: Lee
authors.forename: Sanjay
authors.initials: S
authors.lastname: Purkayastha
authors.forename: Robert
authors.initials: R
authors.lastname: Goldin
authors.forename: Paul
authors.initials: P
authors.lastname: Ziprin