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Date of Award
Spring 2022
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Stephanie Pillai
Abstract
Merkel cell carcinoma (MCC) is a rare form of skin cancer with one of the highest rates of mortalities. Major risk factors include sun exposure, advanced age, light complexion, and immunosuppressive drugs. It usually presents as a lesion that is firm, nontender, and either red or purple in color, and the lesions can grow rapidly. The most common sites of metastases are distant lymph nodes, skin or body wall, liver, and bone; the brain is an uncommon site of MCC metastases, but it is associated with a poor prognosis. In current literature, only 30 cases of brain metastases of MCC have been reported; thus, there is yet to be an official screening or treatment guideline for MCC metastasis to the brain. Current diagnostic modalities include computed tomography and magnetic resonance imaging and are indicated by focal neurologic symptoms on physical exam, however neurologic symptoms often indicate advanced disease. Radiation therapy, chemotherapy, immunotherapy, and surgical resection are all used in the treatment of neurometastatic MCC, but there is not yet an official treatment guideline. More studies are needed for improvement of treatment, more accurate early detection of metastasis, and increased overall survival of neurometastatic Merkel cell carcinoma.
Recommended Citation
McCarthy, Alexandra, "Merkel Cell Carcinoma with Metastasis to the Brain: A Case Study" (2022). Capstone Showcase. 30.
https://scholarworks.arcadia.edu/showcase/2022/pa/30
Merkel Cell Carcinoma with Metastasis to the Brain: A Case Study
Merkel cell carcinoma (MCC) is a rare form of skin cancer with one of the highest rates of mortalities. Major risk factors include sun exposure, advanced age, light complexion, and immunosuppressive drugs. It usually presents as a lesion that is firm, nontender, and either red or purple in color, and the lesions can grow rapidly. The most common sites of metastases are distant lymph nodes, skin or body wall, liver, and bone; the brain is an uncommon site of MCC metastases, but it is associated with a poor prognosis. In current literature, only 30 cases of brain metastases of MCC have been reported; thus, there is yet to be an official screening or treatment guideline for MCC metastasis to the brain. Current diagnostic modalities include computed tomography and magnetic resonance imaging and are indicated by focal neurologic symptoms on physical exam, however neurologic symptoms often indicate advanced disease. Radiation therapy, chemotherapy, immunotherapy, and surgical resection are all used in the treatment of neurometastatic MCC, but there is not yet an official treatment guideline. More studies are needed for improvement of treatment, more accurate early detection of metastasis, and increased overall survival of neurometastatic Merkel cell carcinoma.