Histology: Merkel cell carcinoma is a neuroendocrine tumor. The tumor is composed of small, uniformly shaped, basophilic-staining cells. The tumor is poorly circumscribed and grows in an infiltrative pattern between dermal collagen bundles and subcutaneous fat lobules. The cells have a characteristic nuclear chromatin pattern. These tumors can be stained with various immunohistochemical stains. The most helpful one is the cytokeratin 20 stain. It has a characteristic, if not pathognomonic perinuclear dot, staining pattern.
Treatment: Surgical excision with wide (2-3 cm) margins is still the standard therapeutic treatment. Sentinel node sampling has been helpful in staging. Those patients with localized disease often undergo postoperative irradiation of the surgical removal site. Those with widespread metastatic disease are often treated with cisplatin-based chemotherapeutic regimens.
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