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Merkel Cell Carcinoma: Diagnostic and Therapeutic Challenges —A Case Report with Literature Review
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Radiology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Faculty of Medicine, Pharmacy and Dental Medicine of Fez, University of Sidi Mohamed Ben Abdellah, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
Department of Anatomical Pathology, Hassan II University Hospital, Fez, Morocco
- 1 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 2 Department of Radiology, Hassan II University Hospital, Fez, Morocco
- 3 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 4 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 5 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 6 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 7 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 8 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 9 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 10 Faculty of Medicine, Pharmacy and Dental Medicine of Fez, University of Sidi Mohamed Ben Abdellah, Fez, Morocco
- 11 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 12 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 13 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 14 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 15 Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
- 16 Department of Anatomical Pathology, Hassan II University Hospital, Fez, Morocco
Journal of Cancer Therapy·Volume 17 (2026)·Pages 179–186·Published 2 March 2026·DOI10.4236/jct.2026.173017
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Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine tumor predominantly affecting elderly and immunocompromised patients. It is characterized by a high propensity for local recurrence, regional lymph node involvement, and distant metastasis, leading to poor outcomes. Diagnosis remains challenging due to its rarity and nonspecific presentation, often leading to misdiagnosis. We report a case of locally advanced MCC originating in the gluteal region, exhibiting aggressive behavior. In the Moroccan context, where access to immunotherapy is limited, the patient was managed with chemotherapy, achieving transient disease control within a multimodal treatment strategy. This case report is accompanied by a literature review to discuss current therapeutic strategies and to underscore the challenges in managing MCC in resource-limited settings.
KeywordsMerkel Cell CarcinomaNeuroendocrine TumorGluteal RegionChemotherapyResource-Limited SettingsImmunotherapy
- Lemos, B. and Nghiem, P. (2010) Merkel Cell Carcinoma: More Deaths but Still No Pathway to Blame. CA : A Cancer Journal for Clinicians , 60, 9-11.
- Paulson, K.G., Park, S.Y., Vandeven, N.A., Lachance, K., Thomas, H., Chapuis, A.G., et al . (2018) Merkel Cell Carcinoma: Current US Incidence and Projected Increases Based on Changing Demographics. Journal of the American Academy of Dermatology , 78, 457-463.e2. https://doi.org/10.1016/j.jaad.2017.10.028
- Feng, H., Shuda, M., Chang, Y. and Moore, P.S. (2008) Clonal Integration of a Polyomavirus in Human Merkel Cell Carcinoma. Science , 319, 1096-1100. https://doi.org/10.1126/science.1152586
- Heath, M., Jaimes, N., Lemos, B., Mostaghimi, A., Wang, L.C., Peñas, P.F., et al . (2008) Clinical Characteristics of Merkel Cell Carcinoma at Diagnosis in 195 Patients: The AEIOU Features. Journal of the American Academy of Dermatology , 58, 375-381. https://doi.org/10.1016/j.jaad.2007.11.020
- Becker, J.C., Stang, A., DeCaprio, J.A., et al . (2017) Merkel Cell Carcinoma. The Lancet Oncology , 18, e325-e333.
- Chan, J.K.C., Suster, S., Wenig, B.M., et al . (1997) Cytokeratin 20 Immunoreactivity Distinguishes Merkel Cell (Primary Cutaneous Neuroendocrine) Carcinoma and Small Cell Carcinoma of the Lung. The American Journal of Surgical Pathology , 21, 884-890.
- Kaufman, H.L., Russell, J., Hamid, O., et al . (2016) Avelumab in Patients with Chemotherapy-Refractory Metastatic Merkel Cell Carcinoma: A Multicentre, Single-Group, Open-Label, Phase 2 Trial. The New England Journal of Medicine , 374, 2542-2552.
- Nghiem, P.T., Bhatia, S., Lipson, E.J., Kudchadkar, R.R., Miller, N.J., Annamalai, L., et al . (2016) PD-1 Blockade with Pembrolizumab in Advanced Merkel-Cell Carcinoma. New England Journal of Medicine , 374, 2542-2552. https://doi.org/10.1056/nejmoa1603702
- Iyer, J.G., Blom, A., Doumani, R., et al . (2014) Response Rates and Durability of Chemotherapy among Patients with Advanced Merkel Cell Carcinoma. Cancer , 120, 1527-1536.
- National Comprehensive Cancer Network (NCCN) (2023) NCCN Clinical Practice Guidelines in Oncology: Merkel Cell Carcinoma. Version 2023. Plymouth Meeting, PA: NCCN.
- Lewis, K.G., Weinstock, M.A., Weaver, A.L. and Otley, C.C. (2006) Adjuvant Local Irradiation for Merkel Cell Carcinoma. Journal of the American Academy of Dermatology , 54, 1003-1011.
- Tree, A.C., Khoo, V.S., Eeles, R.A., Ahmed, M., Dearnaley, D.P., Hawkins, M.A., et al . (2013) Stereotactic Body Radiotherapy for Oligometastases. The Lancet Oncology , 14, e28-e37. https://doi.org/10.1016/s1470-2045(12)70510-7