Merkel Cell Carcinoma - A Rare Entity with Specific Reconstructive Challenges

Background: Merkel cell carcinoma is a rare tumor, which is associated with poor prognosis. It has been shown that radical local excision and radiotherapy are essentiell for curative therapy. To avoid compromise in tumor treatment, plastic surgery is often needed. Furthermore, using complex reconstruction methods, like free flap transplantation, has proven to be effective to avoid long and complicated clinical courses. Patients: Between 2003 and 2016 15 patients with Merkel cell carcinoma were treated in our department. In 2 cases additional resection had to take place before reconstruction was performed. In most cases, a safety margin of 2 cm was chosen. Complete excision could be achieved in 13 patients. We used different methods of reconstruction such as primary suturing, skin transplantations, local, pedicled or free flaps. Results: In all patients defects could be reconstructed with good results, which proved to be stable even under postoperative radiation therapy. Conclusion: Given the modern techniques of plastic surgery the extent of local excision should not be should be chosen as radical as possible and necessary. It has been proven that interdisciplinary treatment of patients with Merkel cell carcinoma increases the chances for curative therapy while providing safe methods for reconstruction despite radiotherapy, extensive tumors or difficult localization.