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The Cell Carcinoma ( Mcc )

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MERKEL CELL CARCINOMA

INTRODUCTION
Merkel cell carcinoma (MCC) is a highly aggressive, yet rare type of skin cancer which is associated with a very poor prognosis [1]. The tumor is neuroendocrine and originates from the Merkel cells. ‘Tastzellen’, or touch cells, in the skin which were first described by Friedrich Sigmund Merkel in 1875 [2]. These cells were later renamed as Merkel cells. They are oval shaped receptor cells found in the basal layer of the epidermis of vertebrates. They possess synaptic contacts with various somatosensory afferent nerve fibers and are associated with the sense of touch discrimination of different shapes and textures [3]. In 1972, Toker described five patients with uncommon skin tumors which he named …show more content…

The American Cancer Society predicts the incidence of MCC to soon exceed that of cutaneous T-cell lymphomas and melanomas [13, 14].

The etiology of MCC development is likely multifactorial. Major risk factors include –
• Infection – Evidence of infection with the MCC polyomavirus (MCV) [15].
• Immunosuppression – It’s more seen in people who have undergone organ transplants or people infected with HIV (12 cases of MCC/100,000 people/year) [16-19].
• Old age - The mean age of patients at the time of initial diagnosis ranges from 60-80 years, with an average of 70 years.
• Overexposure to natural or artificial sunlight – People who get high exposure to UV-B radiation naturally (sunlight) or artificially (tanning beds) are more susceptible to this disease. The role of UV-B light in the development of MCC is thought to be due to immunosuppressive action than any mutagenic/carcinogenic effect.
• Fair skin color - Caucasians are most affected by this disease.
• Male gender – Men are more likely than women to develop MCC.

CLINICAL FEATURES AND SYMPTOMS
The presentation of MCC is as a painless, enlarged, rapidly growing, dome-shaped reddish, bluish or purple nodule in a sun-exposed area of the skin of the head and neck or upper extremities [19-21]. Initial size of the nodule is usually less than 2 cm [23]. The simple acronym of the vowels of the English language

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