A 63 year-old man with Merkel cell carcinoma is reported. He noticed an asymptomatic reddish macule on his left lower leg about 8 years previously. The lesion gradually enlarged to a nodule. As the nodule expanded rapidly during past 3 months, he visited our hospital. At his first visit, the lesion was seen as a 70×70mm, indurated reddish plaque accompanied with a dark reddish nodule of 47×45×18mm in size. Biopsy specimen revealed aggregation of atypical small tumor cells, that were immunohistochemically positive for CK20, chromogranine A, and NSE, supporting the diagnosis of Merkel cell carcinoma. We performed wide resection of the primary lesion along with left inguinal lymph node dissection. Inguinal lymph node metastases were confirmed histopathologically. Postoperatively, radiotherapy (50.4Gy XRT) was perfoemed. However, multiple metastases to the liver, pancreas, and distant lymph nodes and local reccurence developed. He was treated with CAV/PE alternating chemotheapy. The metast tic and recurrent lesions reduced, indicating effectiveness of this regimen. After 4 months from the introduction of chemotherapy, the lesions enlarged again. Other regimens of chemotherapy were performed, but he was died due to complication of DIC. [Skin Cancer (Japan) 2001; 16: 51-55]
