Neuroembolization of metastatic Merkel cell cancer to the face for treatment of Kasabach-Merritt syndrome.

Feb 2013

Lee JH, Roychowdhury S, Nissenblatt MJ.

Source

Department of Radiology, UMDNJ Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.

Abstract

Kasabach-Merritt syndrome is defined as a consumptive thrombocytopenia in the presence of a highly vascular tumor. Multiple treatment options, including transarterial embolization, have been described. We demonstrate that transarterial embolization is a viable option in the treatment of a rapidly progressive and debilitating Merkel cell tumor metastasizing to the head and neck presenting with Kasabach-Merritt syndrome.

BMJ - NeuroInterventional Surgery

A review of radiotherapy for merkel cell carcinoma of the head and neck.

2012

Lee J, Poon I, Balogh J, Tsao M, Barnes E.

Source

Odette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.

Abstract

Merkel cell carcinoma of the head and neck (MCCHN) presents a clinical challenge due to its aggressive natural history, unpredictable lymphatic drainage, and high degree of treatment related morbidity. Histological examination of the regional lymph nodes is very important in determining the optimal treatment and is usually achieved by sentinel lymph node biopsy. Radiotherapy plays a critical role in the treatment of most patients with MCCHN. Surgery with adjuvant radiotherapy to the primary tumour site is associated with high local control rates. If lymph nodes are clinically or microscopically positive, adjuvant radiotherapy is indicated to decrease the risk of regional recurrence. The majority of locoregional recurrences occur at the edge or just outside of the radiation field, reflecting both the inherent radiosensitivity of MCC and the importance of relatively large volumes to include "in-transit" dermal lymphatic pathways. When surgical excision of the primary or nodal disease is not feasible, primary radiotherapy alone should be considered as a potentially curative modality and confers good loco-regional control. Concurrent chemoradiotherapy is well tolerated and may further improve outcomes. 

Full text article

PubMed - Journal of Skin Cancer

The role of free tissue transfer in merkel cell carcinoma of the head and neck.

2012

Londino Iii AV, Miles BA.

Source

Department of Otolaryngology, The Mount Sinai Hospital, New York, NY 10029, USA.

Abstract

Merkel cell carcinoma (MCC) is an uncommon neuroendocrine malignancy with a propensity for the head and neck. It typically presents asymptomatically in elderly Caucasians and is characterized by early local and regional spread. There is currently limited data on the appropriate algorithm for treatment of MCC. However, multimodal therapy with wide surgical excision with or without radiation therapy has become standard of care. The location of the primary tumor and intensive adjuvant therapy is often required, provides a challenge to the reconstructive head and neck surgeon. Occasionally, free tissue transfer reconstructive techniques are employed in the reconstruction of MCC defects. This paper will discuss the role of free tissue transfer as a reconstructive option after surgery for advanced head and neck MCC.

PMC