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Epidemiology and Genetics (Including High Risk Patients, Polyomavirus, Prognostic Factors)

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Merkel Cell Carcinoma

Abstract

Merkel cell carcinoma (MCC) is a rare, highly aggressive form of skin cancer that has a strong propensity toward local recurrence, regional nodal metastasis, distant metastasis, and high mortality rates. MCC usually affects elderly white persons and has been described with many different names, given the uncertainty of the cell of origin. The most commonly used names include trabecular carcinoma of the skin, cutaneous neuroendocrine carcinoma, and Merkel cell carcinoma. The name Merkel cell carcinoma was suggested in 1980 and is the most common name used today. The incidence of MCC in the United States is estimated at 0.6 per 100,000 person-years. Because of the rarity of this form of skin cancer, studies have been limited in the past regarding MCC etiologic characteristics, risk factors, prevention strategies, and therapeutic approach. However, population-based data have been accessed recently, mainly from cancer registries, allowing for more detailed information to come to light on the demographic characteristics of primary MCC in the general population. Recently, discoveries of factors that could contribute to the development of MCC have been made, including the identification of the Merkel cell polyomavirus and genetic mutations.

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Abbreviations

CLL:

Chronic lymphocytic leukemia

HIV:

Human immunodeficiency virus

LT:

Large T

MCC:

Merkel cell carcinoma

MCPyV:

Merkel cell polyomavirus

NHL:

Non-Hodgkin lymphoma

NMSC:

Nonmelanoma skin cancer

PUVA:

Psoralen-UV-A

RB:

Retinoblastoma

SEER:

Surveillance, Epidemiology, and End Results

SLNB:

Sentinel lymph node biopsy

References

  1. Medina-Franco H, Urist MM, Fiveash J, Heslin MJ, Bland KI, Beenken SW. Multimodality treatment of Merkel cell carcinoma: case series and literature review of 1024 cases. Ann Surg Oncol. 2001;8:204–8.

    Article  PubMed  CAS  Google Scholar 

  2. Agelli M, Clegg LX, Becker JC, Rollison DE. The etiology and epidemiology of Merkel cell carcinoma. Curr Probl Cancer. 2010;34:14–37.

    Article  PubMed  Google Scholar 

  3. Anderson LL, Phipps TJ, McCollough ML. Neuroendocrine carcinoma of the skin (Merkel cell carcinoma) in a black. J Dermatol Surg Oncol. 1992;18:375–80.

    PubMed  CAS  Google Scholar 

  4. Albores-Saavedra J, Batich K, Chable-Montero F, Sagy N, Schwartz AM, Henson DE. Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study. J Cutan Pathol. 2010;37:20–7.

    Article  PubMed  Google Scholar 

  5. Agelli M, Clegg LX. Epidemiology of primary Merkel cell carcinoma in the United States. J Am Acad Dermatol. 2003;49:832–41.

    Article  PubMed  Google Scholar 

  6. Hodgson NC. Merkel cell carcinoma: changing incidence trends. J Surg Oncol. 2005;89:1–4.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  8. Soltau JB, Smith ME, Custer PL. Merkel cell carcinoma of the eyelid. Am J Ophthalmol. 1996;121:331–2.

    PubMed  CAS  Google Scholar 

  9. Hussain SK, Sundquist J, Hemminki K. Incidence trends of squamous cell and rare skin cancers in the Swedish national cancer registry point to calendar year and age-dependent increases. J Invest Dermatol. 2010;130:1323–8.

    Article  PubMed  CAS  Google Scholar 

  10. Poulsen M, Round C, Keller J, Tripcony L, Veness M. Factors influencing relapse-free survival in Merkel cell carcinoma of the lower limb: a review of 60 cases. Int J Radiat Oncol Biol Phys. 2010;76:393–7.

    Article  PubMed  Google Scholar 

  11. Alzaraa A, Thomas GD, Vodovnik A, Modgill VK. Merkel cell carcinoma in a male breast: a case report. Breast J. 2007;13:517–9.

    Article  PubMed  Google Scholar 

  12. Best TJ, Metcalfe JB, Moore RB, Nguyen GK. Merkel cell carcinoma of the scrotum. Ann Plast Surg. 1994;33:83–5.

    Article  PubMed  CAS  Google Scholar 

  13. Daghistani W, Younan R, Brutus JP. Merkel cell carcinoma of the hand: case report and literature review. Chir Main. 2010;29:128–31.

    Article  PubMed  CAS  Google Scholar 

  14. Tomic S, Warner TF, Messing E, Wilding G. Penile Merkel cell carcinoma. Urology. 1995;45:1062–5.

    Article  PubMed  CAS  Google Scholar 

  15. Hitchcock CL, Bland KI, Laney III RG, Franzini D, Harris B, Copeland III EM. Neuroendocrine (Merkel cell) carcinoma of the skin: its natural history, diagnosis, and treatment. Ann Surg. 1988;207:201–7.

    Article  PubMed  CAS  Google Scholar 

  16. Eng TY, Boersma MG, Fuller CD, et al. A comprehensive review of the treatment of Merkel cell carcinoma. Am J Clin Oncol. 2007;30:624–36.

    Article  PubMed  Google Scholar 

  17. Veness MJ, Perera L, McCourt J, et al. Merkel cell carcinoma: improved outcome with adjuvant radiotherapy. ANZ J Surg. 2005;75:275–81.

    Article  PubMed  Google Scholar 

  18. Lemos B, Nghiem P. Merkel cell carcinoma: more deaths but still no pathway to blame. J Invest Dermatol. 2007;127:2100–3.

    Article  PubMed  CAS  Google Scholar 

  19. Eftekhari F, Wallace S, Silva EG, Lenzi R. Merkel cell carcinoma of the skin: imaging and clinical features in 93 cases. Br J Radiol. 1996;69:226–33.

    Article  PubMed  CAS  Google Scholar 

  20. Heath ML, Nghiem P. Merkel cell carcinoma: if no breslow, then what? J Surg Oncol. 2007;95:614–5.

    Article  PubMed  Google Scholar 

  21. Schmid C, Beham A, Feichtinger J, Aubock L, Dietze O. Recurrent and subsequently metastasizing Merkel cell carcinoma in a 7-year-old girl. Histopathology. 1992;20:437–9.

    Article  PubMed  CAS  Google Scholar 

  22. Sonak RA, Trede K, Gerharz CD. [Merkel cell tumor of the hand in a 104-year-old patient: case report with review of the literature]. Handchir Mikrochir Plast Chir. 1996;28:43–5. German.

    PubMed  CAS  Google Scholar 

  23. Kaae J, Hansen AV, Biggar RJ, et al. Merkel cell carcinoma: incidence, mortality, and risk of other cancers. J Natl Cancer Inst. 2010;102:793–801.

    Article  PubMed  Google Scholar 

  24. Girschik J, Thorn K, Beer TW, Heenan PJ, Fritschi L. Merkel Cell carcinoma in Western Australia: a population-based study of incidence and survival. Br J Dermatol. 2011;165(5):1051–7.

    Article  PubMed  CAS  Google Scholar 

  25. Vilar-Coromina N, Perez Bueno F, Alsina Maqueda M, Vilardell Gil L, Izquierdo Font A, Marcos-Gragera R. [Merkel cell cancer of the skin: population-based incidence and survival 1995–2005]. Med Clin (Barc). 2009;132:701–3.

    Article  Google Scholar 

  26. Kukko H, Bohling T, Koljonen V, et al. Merkel cell carcinoma: a population-based epidemiological study in Finland with a clinical series of 181 cases. Eur J Cancer. 2011;48(5):737–42.

    Article  PubMed  Google Scholar 

  27. Reichgelt BA, Visser O. Epidemiology and survival of Merkel cell carcinoma in the Netherlands: a population-based study of 808 cases in 1993–2007. Eur J Cancer. 2011;47:579–85.

    Article  PubMed  CAS  Google Scholar 

  28. Allen PJ, Bowne WB, Jaques DP, Brennan MF, Busam K, Coit DG. Merkel cell carcinoma: prognosis and treatment of patients from a single institution. J Clin Oncol. 2005;23:2300–9.

    Article  PubMed  Google Scholar 

  29. Miller RW, Rabkin CS. Merkel cell carcinoma and melanoma: etiological similarities and differences. Cancer Epidemiol Biomarkers Prev. 1999;8:153–8.

    PubMed  CAS  Google Scholar 

  30. Heath M, Jaimes N, Lemos B, et al. Clinical characteristics of Merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features. J Am Acad Dermatol. 2008;58:375–81.

    Article  PubMed  Google Scholar 

  31. Paulson KG, Iyer JG, Nghiem P. Asymmetric lateral distribution of melanoma and Merkel cell carcinoma in the United States. J Am Acad Dermatol. 2011;65:35–9.

    Article  PubMed  Google Scholar 

  32. Goessling W, McKee PH, Mayer RJ. Merkel cell carcinoma. J Clin Oncol. 2002;20:588–98.

    Article  PubMed  Google Scholar 

  33. Lunder EJ, Stern RS. Merkel-cell carcinomas in patients treated with methoxsalen and ultraviolet A radiation. N Engl J Med. 1998;339:1247–8.

    Article  PubMed  CAS  Google Scholar 

  34. Mogha A, Fautrel A, Mouchet N, et al. Merkel cell polyomavirus small T antigen mRNA level is increased following in vivo UV-radiation. PLoS One. 2010;5:e11423.

    Article  PubMed  CAS  Google Scholar 

  35. Castle SC, Uyemura K, Fulop T, Makinodan T. Host resistance and immune responses in advanced age. Clin Geriatr Med. 2007;23:463–79, v.

    Google Scholar 

  36. O’Connor WJ, Brodland DG. Merkel cell carcinoma. Dermatol Surg. 1996;22:262–7.

    Article  PubMed  Google Scholar 

  37. Rangwala S, Tsai KY. Roles of the immune system in skin cancer. Br J Dermatol. 2011;165(5):953–65.

    Article  PubMed  CAS  Google Scholar 

  38. Becker JC, Schrama D, Houben R. Merkel cell carcinoma. Cell Mol Life Sci. 2009;66:1–8.

    Article  PubMed  CAS  Google Scholar 

  39. Penn I, First MR. Merkel’s cell carcinoma in organ recipients: report of 41 cases. Transplantation. 1999;68:1717–21.

    Article  PubMed  CAS  Google Scholar 

  40. Gianfreda M, Caiffi S, De Franceschi T, et al. [Merkel cell carcinoma of the skin in a patient with myasthenia gravis]. Minerva Med. 2002;93:219–22.

    PubMed  CAS  Google Scholar 

  41. Lentz SR, Krewson L, Zutter MM. Recurrent neuroendocrine (Merkel cell) carcinoma of the skin presenting as marrow failure in a man with systemic lupus erythematosus. Med Pediatr Oncol. 1993;21:137–41.

    Article  PubMed  CAS  Google Scholar 

  42. Lillis J, Ceilley RI, Nelson P. Merkel cell carcinoma in a patient with autoimmune hepatitis. J Drugs Dermatol. 2005;4:357–9.

    PubMed  Google Scholar 

  43. McLoone NM, McKenna K, Edgar D, Walsh M, Bingham A. Merkel cell carcinoma in a patient with chronic sarcoidosis. Clin Exp Dermatol. 2005;30:580–2.

    Article  PubMed  CAS  Google Scholar 

  44. Nemoto I, Sato-Matsumura KC, Fujita Y, et al. Leukaemic dissemination of Merkel cell carcinoma in a patient with systemic lupus erythematosus. Clin Exp Dermatol. 2008;33:270–2.

    Article  PubMed  CAS  Google Scholar 

  45. Satolli F, Venturi C, Vescovi V, Morrone P, De Panfilis G. Merkel-cell carcinoma in Behçet’s disease. Acta Derm Venereol. 2005;85:79.

    Article  PubMed  Google Scholar 

  46. Lanoy E, Engels EA. Skin cancers associated with autoimmune conditions among elderly adults. Br J Cancer. 2010;103:112–4.

    Article  PubMed  CAS  Google Scholar 

  47. Cohen Y, Amir G, Polliack A. Development and rapid dissemination of Merkel-cell carcinomatosis following therapy with fludarabine and rituximab for relapsing follicular lymphoma. Eur J Haematol. 2002;68:117–9.

    Article  PubMed  Google Scholar 

  48. Gooptu C, Woollons A, Ross J, et al. Merkel cell carcinoma arising after therapeutic immunosuppression. Br J Dermatol. 1997;137:637–41.

    Article  PubMed  CAS  Google Scholar 

  49. Krishna SM, Kim CN. Merkel cell carcinoma in a patient treated with adalimumab: case report. Cutis. 2011;87:81–4.

    PubMed  Google Scholar 

  50. Stone JH, Holbrook JT, Marriott MA, et al. Solid malignancies among patients in the Wegener’s Granulomatosis Etanercept Trial. Arthritis Rheum. 2006;54:1608–18.

    Article  PubMed  CAS  Google Scholar 

  51. Wirges ML, Saporito F, Smith J. Rapid growth of Merkel cell carcinoma after treatment with rituximab. J Drugs Dermatol. 2006;5:180–1.

    PubMed  Google Scholar 

  52. Friedlaender MM, Rubinger D, Rosenbaum E, Amir G, Siguencia E. Temporary regression of Merkel cell carcinoma metastases after cessation of cyclosporine. Transplantation. 2002;73:1849–50.

    Article  PubMed  Google Scholar 

  53. Muirhead R, Ritchie DM. Partial regression of Merkel cell carcinoma in response to withdrawal of azathioprine in an immunosuppression-induced case of metastatic Merkel cell carcinoma. Clin Oncol (R Coll Radiol). 2007;19:96.

    Article  CAS  Google Scholar 

  54. Buell JF, Trofe J, Hanaway MJ, et al. Immunosuppression and Merkel cell cancer. Transplant Proc. 2002;34:1780–1.

    Article  PubMed  CAS  Google Scholar 

  55. Rubel JR, Milford EL, Abdi R. Cutaneous neoplasms in renal transplant recipients. Eur J Dermatol. 2002;12:532–5.

    PubMed  Google Scholar 

  56. Koljonen V, Kukko H, Tukiainen E, et al. Incidence of Merkel cell carcinoma in renal transplant recipients. Nephrol Dial Transplant. 2009;24:3231–5.

    Article  PubMed  Google Scholar 

  57. Bordea C, Wojnarowska F, Millard PR, Doll H, Welsh K, Morris PJ. Skin cancers in renal-transplant recipients occur more frequently than previously recognized in a temperate climate. Transplantation. 2004;77:574–9.

    Article  PubMed  CAS  Google Scholar 

  58. Engels EA, Frisch M, Goedert JJ, Biggar RJ, Miller RW. Merkel cell carcinoma and HIV infection. Lancet. 2002;359:497–8.

    Article  PubMed  Google Scholar 

  59. Izikson L, Nornhold E, Iyer JG, Nghiem P, Zeitouni NC. Merkel cell carcinoma associated with HIV: review of 14 patients. AIDS. 2011;25:119–21.

    Article  PubMed  Google Scholar 

  60. Burack J, Altschuler EL. Sustained remission of metastatic Merkel cell carcinoma with treatment of HIV infection. J R Soc Med. 2003;96:238–9.

    Article  PubMed  Google Scholar 

  61. Adami J, Frisch M, Yuen J, Glimelius B, Melbye M. Evidence of an association between non-Hodgkin’s lymphoma and skin cancer. BMJ. 1995;310:1491–5.

    Article  PubMed  CAS  Google Scholar 

  62. Agnew KL, Ruchlemer R, Catovsky D, Matutes E, Bunker CB. Cutaneous findings in chronic lymphocytic leukaemia. Br J Dermatol. 2004;150:1129–35.

    Article  PubMed  CAS  Google Scholar 

  63. Cantwell M, Hua T, Pappas J, Kipps TJ. Acquired CD40-ligand deficiency in chronic lymphocytic leukemia. Nat Med. 1997;3:984–9.

    Article  PubMed  CAS  Google Scholar 

  64. Lacombe C, Gombert J, Dreyfus B, Brizard A, Preud’Homme JL. Heterogeneity of serum IgG subclass deficiencies in B chronic lymphocytic leukemia. Clin Immunol. 1999;90:128–32.

    Article  PubMed  CAS  Google Scholar 

  65. Kipps TJ. Genetics of chronic lymphocytic leukaemia. Hematol Cell Ther. 2000;42:5–14.

    Article  PubMed  CAS  Google Scholar 

  66. Kipps TJ. Chronic lymphocytic leukemia. Curr Opin Hematol. 2000;7:223–34.

    Article  PubMed  CAS  Google Scholar 

  67. Barroeta JE, Farkas T. Merkel cell carcinoma and chronic lymphocytic leukemia (collision tumor) of the arm: a diagnosis by fine-needle aspiration biopsy. Diagn Cytopathol. 2007;35:293–5.

    Article  PubMed  Google Scholar 

  68. Cervigon I, Gargallo AB, Bahillo C, et al. [Merkel cell carcinoma in a patient with chronic lymphocytic leukemia]. Actas Dermosifiliogr. 2006;97:264–6.

    Article  PubMed  Google Scholar 

  69. Papageorgiou KI, Kaniorou-Larai MG. A case report of Merkel cell carcinoma on chronic lymphocytic leukemia: differential diagnosis of coexisting ­lymphadenopathy and indications for early ­aggressive treatment. BMC Cancer. 2005;5:106.

    Article  PubMed  CAS  Google Scholar 

  70. Quaglino D, Di Leonardo G, Lalli G, et al. Association between chronic lymphocytic leukaemia and secondary tumours: unusual occurrence of a neuroendocrine (Merkel cell) carcinoma. Eur Rev Med Pharmacol Sci. 1997;1:11–6.

    PubMed  CAS  Google Scholar 

  71. Robak E, Biernat W, Krykowski E, Jeziorski A, Robak T. Merkel cell carcinoma in a patient with B-cell chronic lymphocytic leukemia treated with cladribine and rituximab. Leuk Lymphoma. 2005;46:909–14.

    Article  PubMed  Google Scholar 

  72. Vlad R, Woodlock TJ. Merkel cell carcinoma after chronic lymphocytic leukemia: case report and literature review. Am J Clin Oncol. 2003;26:531–4.

    Article  PubMed  Google Scholar 

  73. Ziprin P, Smith S, Salerno G, Rosin RD. Two cases of Merkel cell tumour arising in patients with chronic lymphocytic leukaemia. Br J Dermatol. 2000;142:525–8.

    Article  PubMed  CAS  Google Scholar 

  74. Tadmor T, Aviv A, Polliack A. Merkel cell carcinoma, chronic lymphocytic leukemia and other lymphoproliferative disorders: an old bond with possible new viral ties. Ann Oncol. 2011;22:250–6.

    Article  PubMed  CAS  Google Scholar 

  75. Khezri F, Brewer JD, Weaver AL. Merkel cell carcinoma in the setting of chronic lymphocytic leukemia. Dermatol Surg. 2011;37:1100–5.

    Article  PubMed  CAS  Google Scholar 

  76. Pantulu ND, Pallasch CP, Kurz AK, et al. Detection of a novel truncating Merkel cell polyomavirus large T antigen deletion in chronic lymphocytic leukemia cells. Blood. 2010;116:5280–4.

    Article  PubMed  CAS  Google Scholar 

  77. Howard RA, Dores GM, Curtis RE, Anderson WF, Travis LB. Merkel cell carcinoma and multiple primary cancers. Cancer Epidemiol Biomarkers Prev. 2006;15:1545–9.

    Article  PubMed  Google Scholar 

  78. Brenner B, Sulkes A, Rakowsky E, et al. Second neoplasms in patients with Merkel cell carcinoma. Cancer. 2001;91:1358–62.

    Article  PubMed  CAS  Google Scholar 

  79. Euvrard S, Kanitakis J, Pouteil-Noble C, Claudy A, Touraine JL. Skin cancers in organ transplant recipients. Ann Transplant. 1997;2:28–32.

    PubMed  CAS  Google Scholar 

  80. Popp S, Waltering S, Herbst C, Moll I, Boukamp P. UV-B-type mutations and chromosomal imbalances indicate common pathways for the development of Merkel and skin squamous cell carcinomas. Int J Cancer. 2002;99:352–60.

    Article  PubMed  CAS  Google Scholar 

  81. Walsh NM. Primary neuroendocrine (Merkel cell) carcinoma of the skin: morphologic diversity and implications thereof. Hum Pathol. 2001;32:680–9.

    Article  PubMed  CAS  Google Scholar 

  82. Bzhalava D, Bray F, Storm H, Dillner J. Risk of second cancers after the diagnosis of Merkel cell carcinoma in Scandinavia. Br J Cancer. 2011;104:178–80.

    Article  PubMed  CAS  Google Scholar 

  83. Koljonen V, Kukko H, Tukiainen E, et al. Second cancers following the diagnosis of Merkel cell carcinoma: a nationwide cohort study. Cancer Epidemiol. 2010;34:62–5.

    Article  PubMed  Google Scholar 

  84. Boonchai W, Green A, Ng J, Dicker A, Chenevix-Trench G. Basal cell carcinoma in chronic arsenicism occurring in Queensland, Australia, after ingestion of an asthma medication. J Am Acad Dermatol. 2000;43:664–9.

    Article  PubMed  CAS  Google Scholar 

  85. Lien HC, Tsai TF, Lee YY, Hsiao CH. Merkel cell carcinoma and chronic arsenicism. J Am Acad Dermatol. 1999;41:641–3.

    PubMed  CAS  Google Scholar 

  86. Feng H, Shuda M, Chang Y, Moore PS. Clonal integration of a polyomavirus in human Merkel cell carcinoma. Science. 2008;319:1096–100.

    Article  PubMed  CAS  Google Scholar 

  87. Poulin DL, DeCaprio JA. Is there a role for SV40 in human cancer? J Clin Oncol. 2006;24:4356–65.

    Article  PubMed  CAS  Google Scholar 

  88. Rollison DE, Giuliano AR, Becker JC. New virus associated with Merkel cell carcinoma development. J Natl Compr Canc Netw. 2010;8:874–80.

    PubMed  Google Scholar 

  89. Shuda M, Feng H, Kwun HJ, et al. T antigen mutations are a human tumor-specific signature for Merkel cell polyomavirus. Proc Natl Acad Sci USA. 2008;105:16272–7.

    Article  PubMed  CAS  Google Scholar 

  90. Kassem A, Schopflin A, Diaz C, et al. Frequent detection of Merkel cell polyomavirus in human Merkel cell carcinomas and identification of a unique deletion in the VP1 gene. Cancer Res. 2008;68:5009–13.

    Article  PubMed  CAS  Google Scholar 

  91. Liu X, Hein J, Richardson SC, et al. Merkel cell polyomavirus large T antigen disrupts lysosome clustering by translocating human Vam6p from the cytoplasm to the nucleus. J Biol Chem. 2011;286:17079–90.

    Article  PubMed  CAS  Google Scholar 

  92. Garneski KM, Warcola AH, Feng Q, Kiviat NB, Leonard JH, Nghiem P. Merkel cell polyomavirus is more frequently present in North American than Australian Merkel cell carcinoma tumors. J Invest Dermatol. 2009;129:246–8.

    Article  PubMed  CAS  Google Scholar 

  93. Sastre-Garau X, Peter M, Avril MF, et al. Merkel cell carcinoma of the skin: pathological and molecular evidence for a causative role of MCV in oncogenesis. J Pathol. 2009;218:48–56.

    Article  PubMed  CAS  Google Scholar 

  94. Becker JC, Houben R, Ugurel S, Trefzer U, Pfohler C, Schrama D. MC polyomavirus is frequently present in Merkel cell carcinoma of European patients. J Invest Dermatol. 2009;129:248–50.

    Article  PubMed  CAS  Google Scholar 

  95. Wieland U, Mauch C, Kreuter A, Krieg T, Pfister H. Merkel cell polyomavirus DNA in persons without Merkel cell carcinoma. Emerg Infect Dis. 2009;15:1496–8.

    Article  PubMed  CAS  Google Scholar 

  96. Dworkin AM, Tseng SY, Allain DC, Iwenofu OH, Peters SB, Toland AE. Merkel cell polyomavirus in cutaneous squamous cell carcinoma of immunocompetent individuals. J Invest Dermatol. 2009;129:2868–74.

    Article  PubMed  CAS  Google Scholar 

  97. Pastrana DV, Tolstov YL, Becker JC, Moore PS, Chang Y, Buck CB. Quantitation of human seroresponsiveness to Merkel cell polyomavirus. PLoS Pathog. 2009;5:e1000578.

    Article  PubMed  CAS  Google Scholar 

  98. Kean JM, Rao S, Wang M, Garcea RL. Seroepidemiology of human polyomaviruses. PLoS Pathog. 2009;5:e1000363.

    Article  PubMed  CAS  Google Scholar 

  99. Chen T, Hedman L, Mattila PS, et al. Serological evidence of Merkel cell polyomavirus primary infections in childhood. J Clin Virol. 2011;50:125–9.

    Article  PubMed  CAS  Google Scholar 

  100. Goh S, Lindau C, Tiveljung-Lindell A, Allander T. Merkel cell polyomavirus in respiratory tract secretions. Emerg Infect Dis. 2009;15:489–91.

    Article  PubMed  Google Scholar 

  101. Kuwamoto S. Recent advances in the biology of Merkel cell carcinoma. Hum Pathol. 2011;42:1063–77.

    Article  PubMed  CAS  Google Scholar 

  102. Paulson KG, Lemos BD, Feng B, et al. Array-CGH reveals recurrent genomic changes in Merkel cell carcinoma including amplification of L-Myc. J Invest Dermatol. 2009;129:1547–55.

    Article  PubMed  CAS  Google Scholar 

  103. Houben R, Schrama D, Alb M, et al. Comparable expression and phosphorylation of the retinoblastoma protein in Merkel cell polyoma virus-positive and negative Merkel cell carcinoma. Int J Cancer. 2010;126:796–8.

    Article  PubMed  CAS  Google Scholar 

  104. Lassacher A, Heitzer E, Kerl H, Wolf P. p14ARF hypermethylation is common but INK4a-ARF locus or p53 mutations are rare in Merkel cell carcinoma. J Invest Dermatol. 2008;128:1788–96.

    Article  PubMed  CAS  Google Scholar 

  105. Waltari M, Sihto H, Kukko H, et al. Association of Merkel cell polyomavirus infection with tumor p53, KIT, stem cell factor, PDGFR-alpha and survival in Merkel cell carcinoma. Int J Cancer. 2011;129:619–28.

    Article  PubMed  CAS  Google Scholar 

  106. Bhatia K, Goedert JJ, Modali R, Preiss L, Ayers LW. Merkel cell carcinoma subgroups by Merkel cell polyomavirus DNA relative abundance and oncogene expression. Int J Cancer. 2010;126:2240–6.

    PubMed  CAS  Google Scholar 

  107. Van Gele M, Speleman F, Vandesompele J, Van Roy N, Leonard JH. Characteristic pattern of chromosomal gains and losses in Merkel cell carcinoma detected by comparative genomic hybridization. Cancer Res. 1998;58:1503–8.

    PubMed  Google Scholar 

  108. Gancberg D, Feoli F, Hamels J, et al. Trisomy 6 in Merkel cell carcinoma: a recurrent chromosomal aberration. Histopathology. 2000;37:445–51.

    Article  PubMed  CAS  Google Scholar 

  109. Larramendy ML, Koljonen V, Bohling T, Tukiainen E, Knuutila S. Recurrent DNA copy number changes revealed by comparative genomic hybridization in primary Merkel cell carcinomas. Mod Pathol. 2004;17:561–7.

    Article  PubMed  CAS  Google Scholar 

  110. Wassermann S, Scheel SK, Hiendlmeyer E, et al. p16INK4a is a beta-catenin target gene and indicates low survival in human colorectal tumors. Gastroenterology. 2009;136:196–205 e192.

    Article  PubMed  CAS  Google Scholar 

  111. Panelos J, Batistatou A, Paglierani M, et al. Expression of Notch-1 and alteration of the E-cadherin/beta-catenin cell adhesion complex are observed in primary cutaneous neuroendocrine carcinoma (Merkel cell carcinoma). Mod Pathol. 2009;22:959–68.

    Article  PubMed  CAS  Google Scholar 

  112. Kennedy MM, Blessing K, King G, Kerr KM. Expression of bcl-2 and p53 in Merkel cell carcinoma: an immunohistochemical study. Am J Dermatopathol. 1996;18:273–7.

    Article  PubMed  CAS  Google Scholar 

  113. Plettenberg A, Pammer J, Tschachler E. Merkel cells and Merkel cell carcinoma express the BCL-2 proto-oncogene. Exp Dermatol. 1996;5:102–7.

    Article  PubMed  CAS  Google Scholar 

  114. Schlagbauer-Wadl H, Klosner G, Heere-Ress E, et al. Bcl-2 antisense oligonucleotides (G3139) inhibit Merkel cell carcinoma growth in SCID mice. J Invest Dermatol. 2000;114:725–30.

    Article  PubMed  CAS  Google Scholar 

  115. Brunner M, Thurnher D, Pammer J, et al. Expression of hedgehog signaling molecules in Merkel cell carcinoma. Head Neck. 2010;32:333–40.

    PubMed  Google Scholar 

  116. Kukko HM, Koljonen VS, Tukiainen EJ, Haglund CH, Bohling TO. Vascular invasion is an early event in pathogenesis of Merkel cell carcinoma. Mod Pathol. 2010;23:1151–6.

    Article  PubMed  Google Scholar 

  117. Morrison WH, Peters LJ, Silva EG, Wendt CD, Ang KK, Goepfert H. The essential role of radiation therapy in securing locoregional control of Merkel cell carcinoma. Int J Radiat Oncol Biol Phys. 1990;19:583–91.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  119. Guler-Nizam E, Leiter U, Metzler G, Breuninger H, Garbe C, Eigentler TK. Clinical course and prognostic factors of Merkel cell carcinoma of the skin. Br J Dermatol. 2009;161:90–4.

    Article  PubMed  CAS  Google Scholar 

  120. 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.

    Article  PubMed  CAS  Google Scholar 

  121. Koljonen V, Bohling T, Granhroth G, Tukiainen E. Merkel cell carcinoma: a clinicopathological study of 34 patients. Eur J Surg Oncol. 2003;29:607–10.

    Article  PubMed  CAS  Google Scholar 

  122. Beer TW, Ng LB, Murray K. Mast cells have prognostic value in Merkel cell carcinoma. Am J Dermatopathol. 2008;30:27–30.

    Article  PubMed  Google Scholar 

  123. Fields RC, Busam KJ, Chou JF, et al. Recurrence and survival in patients undergoing sentinel lymph node biopsy for Merkel cell carcinoma: analysis of 153 patients from a single institution. Ann Surg Oncol. 2011;18:2529–37.

    Article  PubMed  Google Scholar 

  124. Sandel IV HD, Day T, Richardson MS, Scarlett M, Gutman KA. Merkel cell carcinoma: does tumor size or depth of invasion correlate with recurrence, metastasis, or patient survival? Laryngoscope. 2006;116:791–5.

    Article  PubMed  Google Scholar 

  125. Goldberg SR, Neifeld JP, Frable WJ. Prognostic value of tumor thickness in patients with Merkel cell carcinoma. J Surg Oncol. 2007;95:618–22.

    Article  PubMed  Google Scholar 

  126. Mott RT, Smoller BR, Morgan MB. Merkel cell carcinoma: a clinicopathologic study with prognostic implications. J Cutan Pathol. 2004;31:217–23.

    Article  PubMed  Google Scholar 

  127. Skelton HG, Smith KJ, Hitchcock CL, McCarthy WF, Lupton GP, Graham JH. Merkel cell carcinoma: analysis of clinical, histologic, and immunohistologic features of 132 cases with relation to survival. J Am Acad Dermatol. 1997;37:734–9.

    Article  PubMed  CAS  Google Scholar 

  128. Llombart B, Monteagudo C, Lopez-Guerrero JA, et al. Clinicopathological and immunohistochemical analysis of 20 cases of Merkel cell carcinoma in search of prognostic markers. Histopathology. 2005;46:622–34.

    Article  PubMed  CAS  Google Scholar 

  129. Lemos BD, Storer BE, Iyer JG, et al. Pathologic nodal evaluation improves prognostic accuracy in Merkel cell carcinoma: analysis of 5823 cases as the basis of the first consensus staging system. J Am Acad Dermatol. 2010;63:751–61.

    Article  PubMed  Google Scholar 

  130. Gupta SG, Wang LC, Penas PF, Gellenthin M, Lee SJ, Nghiem P. Sentinel lymph node biopsy for evaluation and treatment of patients with Merkel cell carcinoma: The Dana-Farber experience and meta-analysis of the literature. Arch Dermatol. 2006;142:685–90.

    Article  PubMed  Google Scholar 

  131. Paulson KG, Carter JJ, Johnson LG, et al. Antibodies to Merkel cell polyomavirus T antigen oncoproteins reflect tumor burden in Merkel cell carcinoma patients. Cancer Res. 2010;70:8388–97.

    Article  PubMed  CAS  Google Scholar 

  132. Jemec B, Chana J, Grover R, Grobbelaar AO. The Merkel cell carcinoma: survival and oncogene markers. J Eur Acad Dermatol Venereol. 2000;14:400–4.

    Article  PubMed  CAS  Google Scholar 

  133. Andea AA, Patel R, Ponnazhagan S, et al. Merkel cell carcinoma: correlation of KIT expression with survival and evaluation of KIT gene mutational status. Hum Pathol. 2010;41:1405–12.

    Article  PubMed  CAS  Google Scholar 

  134. Handschel J, Muller D, Depprich RA, et al. The new polyomavirus (MCPyV) does not affect the clinical course in MCCs. Int J Oral Maxillofac Surg. 2010;39:1086–90.

    Article  PubMed  CAS  Google Scholar 

  135. Sihto H, Kukko H, Koljonen V, Sankila R, Bohling T, Joensuu H. Clinical factors associated with Merkel cell polyomavirus infection in Merkel cell carcinoma. J Natl Cancer Inst. 2009;101:938–45.

    Article  PubMed  CAS  Google Scholar 

  136. Touze A, Gaitan J, Maruani A, et al. Merkel cell polyomavirus strains in patients with Merkel cell carcinoma. Emerg Infect Dis. 2009;15:960–2.

    Article  PubMed  CAS  Google Scholar 

  137. Bhatia K, Goedert JJ, Modali R, Preiss L, Ayers LW. Immunological detection of viral large T antigen identifies a subset of Merkel cell carcinoma tumors with higher viral abundance and better clinical outcome. Int J Cancer. 2010;127:1493–6.

    Article  PubMed  CAS  Google Scholar 

  138. Laude HC, Jonchere B, Maubec E, et al. Distinct Merkel cell polyomavirus molecular features in tumour and non tumour specimens from patients with Merkel cell carcinoma. PLoS Pathog. 2010;6:e1001076.

    Article  PubMed  CAS  Google Scholar 

  139. Touze A, Le Bidre E, Laude H, et al. High levels of antibodies against Merkel cell polyomavirus identify a subset of patients with Merkel cell carcinoma with better clinical outcome. J Clin Oncol. 2011;29:1612–9.

    Article  PubMed  CAS  Google Scholar 

  140. Busam KJ, Jungbluth AA, Rekthman N, et al. Merkel cell polyomavirus expression in Merkel cell carcinomas and its absence in combined tumors and pulmonary neuroendocrine carcinomas. Am J Surg Pathol. 2009;33:1378–85.

    Article  PubMed  Google Scholar 

  141. Carter JJ, Paulson KG, Wipf GC, et al. Association of Merkel cell polyomavirus-specific antibodies with Merkel cell carcinoma. J Natl Cancer Inst. 2009;101:1510–22.

    Article  PubMed  CAS  Google Scholar 

  142. Duncavage EJ, Zehnbauer BA, Pfeifer JD. Prevalence of Merkel cell polyomavirus in Merkel cell carcinoma. Mod Pathol. 2009;22:516–21.

    Article  PubMed  CAS  Google Scholar 

  143. Ridd K, Yu S, Bastian BC. The presence of polyomavirus in non-melanoma skin cancer in organ transplant recipients is rare. J Invest Dermatol. 2009;129:250–2.

    Article  PubMed  CAS  Google Scholar 

  144. Loyo M, Guerrero-Preston R, Brait M, et al. Quantitative detection of Merkel cell virus in human tissues and possible mode of transmission. Int J Cancer. 2010;126:2991–6.

    PubMed  CAS  Google Scholar 

  145. Foulongne V, Kluger N, Dereure O, Brieu N, Guillot B, Segondy M. Merkel cell polyomavirus and Merkel cell carcinoma. France Emerg Infect Dis. 2008;14:1491–3.

    Article  Google Scholar 

  146. Helmbold P, Lahtz C, Enk A, et al. Frequent occurrence of RASSF1A promoter hypermethylation and Merkel cell polyomavirus in Merkel cell carcinoma. Mol Carcinog. 2009;48:903–9.

    Article  PubMed  CAS  Google Scholar 

  147. Andres C, Belloni B, Puchta U, Sander CA, Flaig MJ. Prevalence of MCPyV in Merkel cell carcinoma and non-MCC tumors. J Cutan Pathol. 2010;37:28–34.

    Article  PubMed  Google Scholar 

  148. Varga E, Kiss M, Szabo K, Kemeny L. Detection of Merkel cell polyomavirus DNA in Merkel cell carcinomas. Br J Dermatol. 2009;161:930–2.

    Article  PubMed  CAS  Google Scholar 

  149. Wetzels CT, Hoefnagel JG, Bakkers JM, Dijkman HB, Blokx WA, Melchers WJ. Ultrastructural proof of polyomavirus in Merkel cell carcinoma tumour cells and its absence in small cell carcinoma of the lung. PLoS One. 2009;4:e4958.

    Article  PubMed  CAS  Google Scholar 

  150. Mangana J, Dziunycz P, Kerl K, Dummer R, Cozzio A. Prevalence of Merkel cell polyomavirus among Swiss Merkel cell carcinoma patients. Dermatology. 2010;221:184–8.

    Article  PubMed  CAS  Google Scholar 

  151. Katano H, Ito H, Suzuki Y, et al. Detection of Merkel cell polyomavirus in Merkel cell carcinoma and Kaposi’s sarcoma. J Med Virol. 2009;81:1951–8.

    Article  PubMed  CAS  Google Scholar 

  152. Nakajima H, Takaishi M, Yamamoto M, et al. Screening of the specific polyoma virus as diagnostic and prognostic tools for Merkel cell carcinoma. J Dermatol Sci. 2009;56:211–3.

    Article  PubMed  CAS  Google Scholar 

  153. Kuwamoto S, Higaki H, Kanai K, et al. Association of Merkel cell polyomavirus infection with morphologic differences in Merkel cell carcinoma. Hum Pathol. 2011;42:632–40.

    Article  PubMed  CAS  Google Scholar 

  154. Woo KJ, Choi YL, Jung HS, et al. Merkel cell carcinoma: our experience with seven patients in Korea and a literature review. J Plast Reconstr Aesthet Surg. 2010;63:2064–70.

    Article  PubMed  Google Scholar 

  155. Van Gele M, Kaghad M, Leonard JH, et al. Mutation analysis of P73 and TP53 in Merkel cell carcinoma. Br J Cancer. 2000;82:823–6.

    Article  PubMed  Google Scholar 

  156. Houben R, Michel B, Vetter-Kauczok CS, et al. Absence of classical MAP kinase pathway signalling in Merkel cell carcinoma. J Invest Dermatol. 2006;126:1135–42.

    Article  PubMed  CAS  Google Scholar 

  157. Liu S, Daa T, Kashima K, Kondoh Y, Yokoyama S. The Wnt-signaling pathway is not implicated in tumorigenesis of Merkel cell carcinoma. J Cutan Pathol. 2007;34:22–6.

    Article  PubMed  CAS  Google Scholar 

  158. Swick BL, Ravdel L, Fitzpatrick JE, Robinson WA. Merkel cell carcinoma: evaluation of KIT (CD117) expression and failure to demonstrate activating mutations in the C-KIT proto-oncogene: implications for treatment with imatinib mesylate. J Cutan Pathol. 2007;34:324–9.

    Article  PubMed  Google Scholar 

  159. Van Gele M, Leonard JH, Van Roy N, Cook AL, De Paepe A, Speleman F. Frequent allelic loss at 10q23 but low incidence of PTEN mutations in Merkel cell carcinoma. Int J Cancer. 2001;92:409–13.

    Article  PubMed  Google Scholar 

  160. Agraharkar ML, Cinclair RD, Kuo YF, Daller JA, Shahinian VB. Risk of malignancy with long-term immunosuppression in renal transplant recipients. Kidney Int. 2004;66:383–9.

    Article  PubMed  Google Scholar 

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Lowe, G.C., Brewer, J.D., Bordeaux, J.S. (2013). Epidemiology and Genetics (Including High Risk Patients, Polyomavirus, Prognostic Factors). In: Alam, M., Bordeaux, J., Yu, S. (eds) Merkel Cell Carcinoma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6608-6_2

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