Merkel cell carcinoma of skin (trabecular cancer)
Merkel’s carcinoma is a rare, aggressive form of skin cancer that is more common in older adults of the Caucasian race. The average age at the time of diagnosis is about 75 years. Merkel’s carcinoma can also occur in younger immunosuppressed patients. Experts believe that the factors in the appearance of the pathology are: the cumulative effect of ultraviolet radiation, the effect of Merkel cell polyomavirus, the presence of other forms of cancer (e.g., multiple myeloma, chronic lymphocytic leukaemia, melanoma). Often, the disease spreads lymphogenously.
Symptoms
A person may notice the appearance of dense, shiny knots, flesh or bluish-red. Their most characteristic clinical signs are rapid growth and the absence of pain and soreness. Although Merkel’s carcinoma can affect the skin of any part of the body, it most often occurs in open areas undergoing insolation (for example, facial skin, upper limbs).
Diagnostics
In order to make a correct diagnosis, the specialist uses the following research methods:
- Inspection and history taking;
- Ultrasound examinations;
- Chest x-ray;
- Skeleton bone scintigraphy;
- PET / CT to detect the prevalence of the tumour process.
Then, based on the data obtained, the doctor selects the optimal treatment regimen taking into account the general condition of the patient and the characteristics of the development of pathology.
Treatment
The leading Israeli clinic Tel Aviv Medical Clinic employs experienced doctors who use combination therapy. The main treatment option for the primary tumour in the absence of distant metastasis is surgical. In the presence of metastatic lesions of the lymph nodes, lymphadenectomy is necessary. In the absence of clinical and instrumental data on the presence of a metastatic lesion of the regional lymph nodes, a biopsy of the sentinel lymph node is indicated. This method allows revealing micrometastases to regional lymph nodes in almost a third of patients with local stages.
If surgical excision of the tumour is not possible, a dose of ionizing radiation is recommended. As the first line of therapy in patients with a metastatic or locally advanced inoperable process, chemotherapy is recommended: a combination of etoposide with platinum preparations. The best results as the therapy of the first and subsequent lines were demonstrated by immuno-oncological therapy. Thus, our doctors manage to help even in the most difficult situations.