Merkel cell carcinoma of the head and neck: a retrospective case series

Background. Eighty-five percent of all Merkel cell carcinomas appear on sun-exposed areas, with 50% to 55% occurring on the head and neck. Methods. A chart review was performed on 22 patients treated for Merkel cell carcinoma of the head and neck between 1981 and 1998. Results. Fifteen patients were men (68%). The average age at operation was 69.9 years (range, 24-84 years). The average duration of follow-up was 3.6 years (range, 3 days-8.6 years). Overall survival at 1, 2, and 3 years postoperatively was 78%, 68%, and 68%, respectively. The only independent predictor of survival was the type of surgical therapy. All patients who underwent wide local excision (WLE) of the primary tumor with dissection of the lymphatic drainage basin were alive at 2 years as opposed to 68% who had WLE alone and 33% who had Mohs surgery. Conclusions. WLE and dissection of the lymphatic drainage basin provided the best overall survival.