Poster Presentation Joint Scientific Meeting of the Australian & NZ Head & Neck Cancer Society & NZ Association of Plastic Surgeons

A case report and literature review of large early in-transit metastasis of stage I merkel cell carcinoma (1426)

Fraser Donaldson 1 , Alistair Mccombe 1 , Mohit Jain 1 , Sorensen Kristian 1
  1. Plastic and Reconstructive Surgery, Cairns Hospital, Cairns, Queensland, Australia

Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy with a well-documented propensity for regional and distant metastasis. The rate of MCC metastasis to regional lymph nodes is reported at 23-45%, hence the consensus guidelines put forward by The American Joint Committee on Cancer (AJCC) and National Comprehensive Cancer Network (NCCN), recommending sentinel lymph node biopsy for clinically node-negative patients with MCC. Information regarding regional in-transit metastasis of MCC whilst scarce suggests that this is uncommon. We present a case of a 69-year-old male with a MCC of his forehead and no palpable lymphadenopathy. He underwent wide local excision with clear margins and a negative sentinel lymph node biopsy (pathological stage I), followed by adjuvant radiotherapy. He re-presented 10 months following his initial definitive excision and treatment with a massive dermal metastatic deposit in the ipsilateral temporal region. We also review the available literature on patterns and risk factors for MCC metastasis in general, with a particular focus on in-transit metastasis.

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