Merkel Cell Carcinoma Information, Facts and Resources

Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer. A thorough diagnosis and appropriate treatment options are essential to cure this disease. Fred Hutch Cancer Center offers comprehensive treatment from a team of experts who specialize in MCC.

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What Is Merkel Cell Carcinoma?

Merkel cells are cells normally in the bottom layer of your epidermis — the outermost layer of the two main layers of your skin (the dermis is the deeper layer). They function mainly as touch receptors and relay touch-related information, such as texture and pressure, to your brain.

Scientists studying these cells believe that MCC doesn’t actually start with normal Merkel cells. Instead, it’s more likely that the stem cells in the skin that normally produce Merkel cells can also, in some cases, develop into Merkel cell carcinoma. More MCC facts:

  • MCC usually appears as a lump that has grown rapidly on sun-exposed areas of the head, neck, arms or legs, but it can also appear in areas typically protected from the sun.
  • MCC often metastasizes (spreads) to other parts of the body. Even small tumors may metastasize.
  • When the disease spreads, it often spreads to nearby lymph nodes and may also spread to the liver, bone, lungs and brain.

Understanding Merkel Cell Carcinoma

Symptoms

Merkel cell carcinoma usually causes lumps or tumors on the skin that are:

  • Firm, painless, shiny
  • Skin colored, or red or purple
  • As small as a quarter of an inch to more than two inches

It often resembles a benign (noncancerous) lesion, such as a cyst.

Learn About Symptoms of MCC

Stages

Your care team will recommend treatment based on the stage of your cancer.

The stage depends on the following:

  • The size of your primary tumor
  • The extent of disease in your lymph nodes and elsewhere in your body

Merkel cell carcinomas are grouped into stages I (1) through IV (4). Stage I is the least advanced, and stage IV is the most advanced.

Learn About Stages of MCC

Merkel Cell Carcinoma Facts FAQ

Merkel cell carcinoma is relatively rare, with about 2,500 people newly diagnosed each year in the United States. The incidence (rate of new cases per year) has tripled in the past 15 years, mainly because the baby-boom generation is aging. Merkel cell carcinoma is more common after age 65.

Merkel cell carcinoma usually is caused in part by an extremely common — and typically harmless — virus that was discovered in 2008, the Merkel cell polyomavirus. Another cause is extensive exposure to sunlight, especially in people with fair skin. This exposure can occur at any time, including childhood. About 80% of MCC cases are caused by the Merkel cell polyomavirus, and about 20% are caused by extensive sun damage. 

People who have significant, prolonged suppression of their immune system (such as after a kidney or heart transplant or due to infection with human immunodeficiency virus, HIV) are at high risk of MCC, but over 90% of MCC patients have no known problem with their immune system.

Merkel cell carcinoma is diagnosed with a skin biopsy, which means samples of cells are taken from the tumor and examined under a microscope by a pathologist. Common types of biopsy include a punch biopsy (a small cylinder of tissue is taken) or a shave biopsy (part of the top of the abnormal tissue is removed with a scalpel).

Special stains are used to distinguish this cancer from other forms of cancer, such as small cell lung cancer, lymphoma, melanoma or other sun-induced skin cancers, and from benign (noncancerous) cysts.