Distant Metastasis of Merkel Cell Carcinoma: A Descriptive Study
Keywords:
Merkel cell carcinoma, Metastasis, Skin, Neuroendocrine tumor, Cutaneous malignancyAbstract
Introduction: There are few studies on the pattern of distant spread of Merkel cell carcinoma (MCC).
Objectives: We aimed to analyze the most frequent locations of distant metastases from MCC and their possible relationship with the location of the primary tumor.
Methods: Patients diagnosed with cutaneous MCC between 1988 and 2022 were included in the study. The locations of the first metastasis detected were recorded, both at tumor diagnosis and during follow-up after initial treatment.
Results: In 100 diagnosed with MCC, distant metastases were detected in 31 patients (7 at diagnosis and 24 during follow-up), with a total of 52 locations: 17 non-regional lymph node metastases, 10 bone, 7 liver, 6 lung, 4 non-regional cutaneous/subcutaneous, 3 pancreatic, 2 adrenal, 2 pharyngeal, and 1 mammary. No patients developed metastasis to the central nervous system (CNS). Recurrences occurred in 84% of patients before 2 years of follow-up. Although differences were not significant, MCCs located in the extremities tended to metastasize to extra-regional lymph nodes and those in the head and neck to bone, liver, and lung.
Conclusions: MCC produces metastases mainly in non-regional lymph nodes, bone, liver, and lung. Given its high frequency (one-third of patients), we consider it advisable to perform scheduled imaging tests during the first 2 years of follow-up. Specific imaging tests for CNS could be reserved for patients with neurological symptoms.
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Copyright (c) 2025 Clara Muntaner-Virgili, Júlia Boronat-Cucarull, Josep Ramon Ferreres, Marta Gamissans, Joaquim Marcoval, Davinia Fernández-Calvo, Rosa María Penín, Josep Bermejo, Lia Huesa-Barceló, Sergio Manzano-Mora, Eric Ruzafa-Martínez, María Teresa Bajén-Lázaro, Ana Benítez-Segura, Paula Cecilia Notta, Laura Jiménez-Colomo, Juan Martín-Liberal, Pablo Araguas-Mora, Marc Juárez-Lozano, Isabel Linares-Galiana
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