Skip to main content
SpringerLink
Log in

Primäre Strahlentherapie eines rezidivierenden Merkel-Zell-Karzinoms des Lides

Radical radiotherapy of recurrent Merkel-Cell-carcinoma of the eyelid. Case report and review of the literature

Kasuistik und Literaturübersicht

  • Originalarbeit
  • Published:
Strahlentherapie und Onkologie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Trotz einer zunehmenden Zahl an Berichten ist das Merkel-Zell-Karzinom eine seltene Erkrankung. Berichte über eine primäre Strahlentherapie sind selten.

Patient und Methode

Bei einer 84jährigen Patientin mit lokal rezidiviertem Merkel-Zell-Karzinom am Oberlid erfolgte eine primäre hypofraktionierte Strahlentherapie mit 70-kV-Röntgenstrahlen (50 Gy in zehn Fraktionen von je 5 Gy über fünf Wochen).

Ergebnis

Der Tumor zeigte eine rasch einsetzende komplette Remission, 24 Monate nach Ende der Therapie ist die Patientin ohne Hinweis auf ein Lokalrezidiv oder Fernmetastasen.

Schlußfolgerung

Der vorgestellte Fall bestätigt erneut die Strahlenempfindlichkeit des Tumors und unterstreicht die Bedeutung der Radiotherapie nicht nur als Salvage-Maßnahme.

Abstract

Background

Despite an increasing number of reports Merkel-cell-carcinoma still is a rare neoplasm. Reports on radical radiotherapy are sparse.

Patient and Method

We report on a successful radical radiotherapy of a recurrent Merkel-cell-carcinoma of the eyelid in an 84-year old woman, using a hypofractionated treatment of 50 Gy with 70 kV-X-rays, 10 fractions of 5 Gy within 5 weeks.

Result

Rapid and complete remission was achieved, with no signs of local or distant failure 24 months after the end of therapy.

Conclusion

The case reported on highlights the radiosensitivity of this tumor and the role of radiotherapy not merely as salvage procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Ashby M, Jones D, Tasker A, et al. Primary cutaneous neuroendocrine (Merkel cell trabecular carcinoma) tumour of the skin: a radioresponsive tumour. Clin Radiol 1989;40:85–7.

    Article  PubMed  CAS  Google Scholar 

  2. Bielamowicz S, Smith D, Abemayor E. Merkel cell carcinoma: an aggressive skin neoplasm. Laryngoscope 1994;104:528–32.

    Article  PubMed  CAS  Google Scholar 

  3. Boyle F, Pendlebury S, Bell D. Further insights into the natural history and management of primary cutaneous neuroendocrine (Merkel cell) carcinoma. Int J Radiat Oncol Biol Phys (1995):31:315–23.

    PubMed  CAS  Google Scholar 

  4. Brierley J, Stockdale A, Rostom A. Merkel cell (trabecular) carcinoma of the skin treated by radiotherapy. Clin Oncol 1991;3:117–8.

    Article  CAS  Google Scholar 

  5. Champion R, Gloor F, Speiser P, et al. Merkelzelltumor des Lides. Klin Mbl Augenheilk 1982;180:480–2.

    Article  Google Scholar 

  6. Fenig E, Lurie H, Klein B, et al. The treatment of advanced Merkel cell carcinoma. A multimodality chemotherapy and radiation therapy treatment approach. J derm Surg Oncol 1993;19:860–4.

    CAS  Google Scholar 

  7. Ferrau F, Micali G, Guitart J. Merkel cell carcinoma of the scalp: dramatic resolution with primary chemotherapy. J Amer Acad Derm 1994;31: 271–2.

    Article  CAS  Google Scholar 

  8. Foster R, Stevens G, Egan M. An unusual pattern of metastases from Merkel cell carcinoma. Aust Radiol 1994;38:231–2.

    Article  CAS  Google Scholar 

  9. Gibas Z, Weil S, Chen S, et al. Deletion of chromosome arm 1p in a Merkel cell carcinoma. Gen Chromosom Cancer 1994;9:216–20.

    Article  CAS  Google Scholar 

  10. Haag M, Glass L, Fenske N, Merkel cell carcinoma. Diagnosis and treatment. Derm Surg 1995;21:669–83.

    Article  CAS  Google Scholar 

  11. Hamilton J, Levine M, Lash R, et al. Surgical reviews: Merkel cell carcinoma of the eyelid. Ophthal Surg 1993;24:764–9.

    CAS  Google Scholar 

  12. Hasle H. Merkel cell carcinoma: the role of primary treatment with radio-therapy. Clin Oncol 1991;3:114–6.

    Article  CAS  Google Scholar 

  13. Hitchcock C, Bland K, Laney R, et al. Neuroendocrine (Merkel cell) carcinoma of the skin. Its natural history, diagnosis and treatment. Ann Surg 1988;207:201–7.

    Article  PubMed  CAS  Google Scholar 

  14. Kivelä T, Tarkkanen A. The Merkel cell and associated neoplasms in the eyelids and periocular region. Surv Ophthal 1990;35:171–87.

    Article  Google Scholar 

  15. Knox S, Kapp D. Hyperthermia and radiation therapy in the treatment of recurrent Merkel cell tumours. Cancer 1988;62:1479–86.

    Article  PubMed  CAS  Google Scholar 

  16. Leonard J, Leonard P, Kearsley J. Chromosomes 1, 11, and 13 are frequently involved in karyotypic abnormalities in metastatic Merkel cell carcinoma. Cancer Genet Cytogenet 1993;67:65–70.

    Article  PubMed  CAS  Google Scholar 

  17. Mäurer J, Busch M, Matthaei D, et al. Kasuistische Beiträge zur Bedeutung der lokoregionären Strahlentherapie des Merkel-Zell-Tumors. Strahlenther Onkol 1992;168:536–40.

    PubMed  Google Scholar 

  18. Meeuwissen J, Bourne R, Kearsley J. The importance of postoperative radiation therapy in the treatment of Merkel cell carcinoma. Int J Radiat Oncol Biol Phys 1995;31:325–31.

    PubMed  CAS  Google Scholar 

  19. Milewski C, Krummel F, Dienes H. Das Merkelzellkarzinom: Ein endokrin differenzierter Tumor im Kopf-Hals-Bereich. Laryngo-Rhino-Otol 1991;70:142–5.

    Article  CAS  Google Scholar 

  20. Morrison W, Peters L, Silva E, et al. The essential role of radiation therapy in securing locoregional control of Merkel cell carcinoma. Int J Radiat Oncol Biol Phys 1990;19:583–91.

    PubMed  CAS  Google Scholar 

  21. O'Connor W, Brodland D. Merkel cell carcinoma. Derm Surg 1996;22:262–7.

    Article  Google Scholar 

  22. Pacella J, Ashby M, Ainslie J, et al. The role of radiotherapy in the management of primary cutaneous neuroendocrine tumors (Merkel cell or trabecular carcinoma): experience at the Peter MacCallum Cancer Institute (Melbourne, Australia). Int J Radiat Oncol Biol Phys 1988;14:1077–84.

    PubMed  CAS  Google Scholar 

  23. Pectasides D, Moutzourides G, Dimitriadis M, et al. Chemotherapy for Merkel cell carcinoma with carboplatin and etoposide. Amer J clin Oncol 1995;18:418–20.

    CAS  Google Scholar 

  24. Pilotti S, Rilke F, Bartoli C, et al. Clinicopathologic correlations of cutaneous neuroendocrine Merkel cell carcinomas. J clin Oncol 1988;6:1863–73.

    PubMed  CAS  Google Scholar 

  25. Pople I. Merkel cell tumour of the face successfully treated with radical radiotherapy. Europ J Surg Oncol 1988;14:79–81.

    CAS  Google Scholar 

  26. Proenca R, Santos M, Cunha-Vaz J. Primary neuroendocrine carcinoma of the eyelid, immunohistochemical and ultrastructural study. Int Ophthal 1990;114:251–8.

    Article  Google Scholar 

  27. Purgason P, Hornblass A, Harrison W. Metastatic Merkel cell carcinoma to the eye. Opthalmology 1991;98:1432–4.

    CAS  Google Scholar 

  28. Rubsamen P, Tanenbaum M, Grove A, et al. Merkel cell carcinoma of the eyelid and periocular tissues. Amer J Ophthal 1992;113:674–80.

    PubMed  CAS  Google Scholar 

  29. Singh A, Eagle R, Shields C, et al. Merkel cell carcinoma of the eyelids. Int Ophthal Clin 1993;33:11–7.

    Article  PubMed  CAS  Google Scholar 

  30. Smith D, Bielamowicz S, Kagan A, et al. Cutaneous neuroendocrine (Merkel cell) carcinoma. A report of 35 cases. Amer J clin Oncol 1995;18: 199–203.

    Article  CAS  Google Scholar 

  31. Soltau J, Smith M, Custer P. Merkel cell carcinoma of the eyelid. Amer J Ophthal 1996;121:331–2.

    PubMed  CAS  Google Scholar 

  32. Suntharalingam M, Rudoltz M, Mendenhall W, et al. Radiotherapy for Merkel cell carcinoma of the skin of the head and neck. Head Neck 1995;17:96–101.

    Article  PubMed  CAS  Google Scholar 

  33. Takes R, Balm A, Loftus B, et al. Merkel cell carcinoma of the head and neck. Clin Otolaryng 1994;19:222–9.

    Article  CAS  Google Scholar 

  34. Toker C. Trabekular carcinoma of the skin. Arch Derm 1972;105:107–10.

    Article  PubMed  CAS  Google Scholar 

  35. Westgate S. Radiation therapy for skin tumors. Otolaryngol Clin N Amer 1993;26:295–309.

    CAS  Google Scholar 

  36. Wilder R, Harari P, Graham A, et al. Merkel cell carcinoma. Improved locoregional control with postoperative radiation therapy. Cancer 1991;68:1004–8.

    Article  PubMed  CAS  Google Scholar 

  37. Yiengpruksawan A, Coit D, Thaler H, et al. Merkel cell carcinoma. Prognosis and management. Arch Surg 1991;126:1514–9.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hermann-Holthusen-Institut für Strahlentherapie, Allgemeines Krankenhaus St. Georg, Hamburg

    Stefan Höcht

  2. Abteilung Strahlentherapie, Universitätsklinikum Benjamin Franklin der Freien Universität Berlin, Hindenburgdamm 30, D-12200, Berlin

    Stefan Höcht & Thomas Wiegel

Authors
  1. Stefan Höcht
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Wiegel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefan Höcht.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Höcht, S., Wiegel, T. Primäre Strahlentherapie eines rezidivierenden Merkel-Zell-Karzinoms des Lides. Strahlenther Onkol 174, 311–314 (1998). https://doi.org/10.1007/BF03038545

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03038545

Schlüsselwörter

Key Words

Search

Navigation