Merkel cell carcinoma is a rare type of skin cancer that usually appears as a flesh-colored or bluish-red nodule, often on your face, head or neck. Merkel cell carcinoma is also called neuroendocrine carcinoma of the skin.

Merkel cell carcinoma most often develops in older people. Long-term sun exposure or a weak immune system may increase your risk of developing Merkel cell carcinoma.

Merkel cell carcinoma tends to grow fast and to spread quickly to other parts of your body. Treatment options for Merkel cell carcinoma often depend on whether the cancer has spread beyond the skin.

Symptoms

The first sign of Merkel cell carcinoma is usually a fast-growing, painless nodule (tumor) on your skin. The nodule may be skin-colored or may appear in shades of red, blue or purple. Most Merkel cell carcinomas appear on the face, head or neck, but they can develop anywhere on your body, even on areas not exposed to sunlight.

Causes

It's not clear what causes Merkel cell carcinoma. Merkel cell carcinoma begins in the Merkel cells. Merkel cells are found at the base of the outermost layer of your skin (epidermis). Merkel cells are connected to the nerve endings in the skin that are responsible for the sense of touch.

Researchers recently discovered that a common virus plays a role in causing most cases of Merkel cell carcinoma. The virus (Merkel cell polyomavirus) lives on the skin and doesn't cause any signs or symptoms. Just how this virus causes Merkel cell carcinoma has yet to be determined. Given that the virus is very common and Merkel cell carcinoma is very rare, it's likely that other risk factors play a role in the development of this cancer.

Prevention

• Avoid the sun during peak hours
• Shield your skin and eyes
• Apply sunscreen liberally and often
• Watch for changes

Diagnosis

Tests and procedures used to diagnose Merkel cell carcinoma include:

• Physical exam. Your doctor will examine your skin for unusual moles, freckles, pigmented spots and other growths.
• Removing a sample of suspicious skin. During a procedure called a skin biopsy, your doctor removes the tumor or a sample of the tumor from your skin. The sample is analyzed in a laboratory to look for signs of cancer.
• Sentinel node biopsy
• Imaging tests

Treatment

Treatments for Merkel cell carcinoma can include:

• Surgery
• Radiation therapy
• Immunotherapy
• Chemotherapy

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