Merkel cell carcinoma of the face: follow-up report of 10 cases in Germany

Merkel cell carcinoma is a rare cutaneous neoplasm in older adults that has a high propensity for nodal metastases and local recurrence, has poor prognosis, and in the last few years has increased in incidence. We retrospectively review our experience of the surgical treatment of Merkel cell carcinoma of the face in 10 patients (9 women and 1 man) between 1993 and 2007. Follow-up ranged from 5 to 132 months (mean 38.8, median 29). Relapse-free survival for all patients was 47% at 2 years. We support the need for complete excision with wide 2-3 cm margins throughout all tumour stages although this might be limited when it affects the face. We also recommend radiotherapy for patients with disease that is stage II and above; the value of adjuvant radiotherapy is outlined in many studies. Therapeutic functional neck dissection should be done in cases of nodal disease. The role of chemotherapy is still not clear, and it has not been used in our department.