Surgical Management of Head and Neck Merkel Cell Carcinoma, are we doing Enough?Fergal O’Duffy*, Tadhg O’Dwyer and Samir Gendy
Department of Otolaryngology Head and Neck Surgery, the Mater Misericordiae University Hospital, Dublin, Ireland
- Corresponding Author:
- Fergal Oâ€™Duffy
ENT Department Mater Misericordiae Hospital
Eccles street, Dublin 7, Ireland
Tel: 00 353 1 8034347
Fax: 00 353 1 8034779
E-mail: [email protected]
Received date: September 29, 2014; Accepted date: October 14, 2014; Published date: October 23, 2014
Citation: Duffy FO, Dwyer TO, Gendy S (2014) Surgical Management of Head and Neck Merkel Cell Carcinoma, are we doing Enough? Otolaryngol (Sunnyvale) 4:177. doi:10.4172/2161-119X.1000177
Copyright: © 2014 Duffy FO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A case series and critical review of the current understanding and guidelines in management of Merkel cell carcinoma are presented. Merkel Cell Carcinoma of the head and neck is highly aggressive and has less predictable lymphatic drainage that that of the trunk and limbs. Variable surgical management strategies exist for the node negative neck including observation, radiation and prophylactic neck dissection. Current National Comprehensive Cancer Network Guidelines [NCCN] advocate radiation treatment and Sentinel Node Biopsy [SLNB] for the node negative neck. A potential pitfall of this management is the reduced accuracy of SLNB in the neck due to variable lymphatic drainage. Also the short to long term morbidity of irradiating the neck should not be underestimated. Merkel cell carcinoma is highly aggressive with micro metastasis reported at rates of 23% to 100%. In experienced surgical hands neck dissection in clinically node negative neck can provide excellent disease control with low morbidity and should be considered in the management of head and neck Merkel cell carcinoma.