What Is Merkel Cell Carcinoma Of The Eyelid & Merkel Cell Carcinoma Of Thigh?

Merkel cells are receptors formed of neuroendocrine cells which are connected by nerve endings and these take the sensation of touch and vibration to the brain and are located in the epidermis. These are not only located in the skin of head and neck areas but all over the body skin surface.

The most commonly accounted reason for the development of this cancer is prolonged exposure to the sunlight, in particular, the ultraviolet rays. The UV rays can lead to mutations in the genetics of the skin cells and the most commonly found gene to be mutated is the Tp53 gene. It is a tumor suppressor gene and its suppression can lead to stimulation of oncogenes which are responsible for reducing the cell death and increasing its uninhibited proliferation rate. Exposure to the ionizing radiation such as X-ray, Gamma rays, etc. and Immunosuppression is also working as triggering factors of the skin cancer[1].

What Is Merkel Cell Carcinoma Of The Eyelid?

What Is Merkel Cell Carcinoma Of The Eyelid?

The commonly found sites of the Merkel cell carcinoma are head and neck. Eyelids are very common sites for the development of Merkel cell carcinoma because these are supplied richly by nerves and Merkel cells have a high density that is they are more in number per square centimeter in that area. Merkel cell carcinoma usually presents as nodule of the small size usually arising from the margin of the eyelids. The nodule changes it’s the and can present in various colours like red, blue, purple, etc.

The best treatment and also the treatment of choice for Merkel cell cancer of eyelids is surgical treatment. Surgical resection of the nodule or small tumor along with the eyelid will probably be sufficient. Plastic surgery with autograft could be done later to fill the gap created by resection of the eyelid. Moh’s microsurgery can also be performed is the lesion is small. It ensures that the margins of the resected tissues are having healthy tissue which almost nils the probability of relapse of the cancerous changes.

What Is Merkel Cell Carcinoma Of?

The Merkel cell carcinoma of the thigh is not a common finding because of the very low density of Merkel cells in the area around the thighs and also it is usually not exposed to sunlight and ultraviolet radiation. Only very few cases are known for it to be a primary site for Merkel cell carcinoma. It can, however, occur sometimes due to metastatic throwing off the small cancerous tissues as embolus from the primary site via colorhematogenous route to thighs and other body parts which are very less exposed to sunlight as compared to head and neck regions.

But if the Merkel cell carcinoma, on thighs, it probably has resulted from metastasis from underlying tumor already present at some other site which makes it the last stage cancer. It has a very poor prognosis with a 5-year survival rate to almost nil. Surgical resection cannot be performed for treatment because the stage has already crossed its limit and has spread extensively but can only be done for palliation treatment. Chemotherapy could be tried in such cases with recombinant drugs like imatinib and pembrolizumab being used as a last stage treatment method.[1]

Conclusion

The commonest of sites for Merkel cell carcinoma to be found are highly sunlight exposed areas like face and neck regions along with the small region of the chest. Surgical resection of the cancerous nodule of the eyelid is the treatment of choice and performing further lymph node resection, radical neck dissection, etc. is done in high-risk patients or having nodule of size ranging in few centimeters.

The Merkel cell carcinoma of thighs is resected only if these are found to be primary which are very few numbers of cases. If these are secondary then these are to be treated with medical treatment. Recombinant anticancer drugs are more useful in such cases. Being rare cancer not much is known about the exact mechanism of its development and the drugs effective in its treatment.

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