A case of Merkel cell carcinoma on the buttock with multiple liver metastases

Abstract

A 68-year-old male patient was seen at our hospital in June 2003 with a subcutaneous tumor on the right buttock of one month's duration accompanied by the enlargement of the right inguinal lymph node. The tumor was histopathologically diagnosed as Merkel cell carcinoma (MCC). After resection with wide margin and lymph node dissection, we added X-ray irradiation in order to prevent local recurrence. He attained complete remission for twenty months. A follow-up CT in April 2005 revealed multiple liver metastases and the serological NSE level was 240ng/ml. First he was treated with EP regimen which was shown to be ineffective. We switched to CAV regimen resulting in complete remission. After a two-month duration of CR, a recurrence of MCC metastatic lesions was detected in the liver and pleura. Amrubicin wasn't effective. The selection of chemo-regimens of MCC is controversial. Further clinical study should reveal the optimal chemo-regimens in the treatment of MCC. [Skin Cancer (Japan) 2006; 21: 314-317]