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Dr. Gregory K. Robbins (Infectious Diseases): A 63-year-old man was referred to the clinic for head and neck cancer, a multidisciplinary unit of this hospital, for management of cutaneous Merkel-cell carcinoma. He had been well until 3 months earlier, when he noted a small, painless nodule on the superior, right-central aspect of his forehead. During the next 3 weeks, this nodule grew slowly, and a second, pea-size, painless nodule developed in front of his right ear. Pathological examination of a biopsy specimen of the lesion on the forehead indicated a small-cell carcinoma that was thought to be consistent with Merkel-cell
Pathological Discussion
Discussion of Management
Decision Making for Stage II Merkel-Cell Carcinoma
Anatomical Diagnosis
Source Information
From the Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School (P.M.B.); the Department of Hematology–Oncology, Massachusetts General Hospital, and the Department of Medicine, Harvard Medical School (J.R.C.); the Department of Radiology, Massachusetts General Hospital and Harvard Medical School (V.V.M.); and the Departments of Dermatology and Pathology, University of Iowa Carver College of Medicine, Iowa City (V.L.).
Related Letters:
Case 19-2008: Merkel-Cell Carcinoma
Lemos B. D., Yu S. S., Nghiem P., Wong S. L., Lao C. D., Bichakjian C. K., Busse P. M., Clark J. R.
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N Engl J Med 2008;
359:1629-1631, Oct 9, 2008.
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