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Therapeutic Approach

Merkel cell carcinoma (MCC) is an aggressive skin cancer with a high risk of local recurrence and distant metastasis. Risk of recurrence is 25% to 75% based on initial stage at diagnosis. Optimal treatment of this potentially life-threatening cancer is rapidly evolving across multiple specialties and requires multidisciplinary consultation.

Treatment pearls: For most patients, after initial biopsy diagnosis, prompt referral to an academic center, whole body PET/CT imaging, and a baseline Merkel polyomavirus oncoprotein antibody titera are helpful first steps in management.a To order: See Tables 105-1 and 105-2.

Table 105-1Merkel Cell Carcinoma Treatment Flowcharts
Table 105-2Merkel Cell Carcinoma Treatment Table for Systemic Medications


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