Merkel cell carcinoma of penis.

Merkel cell carcinoma of penis. We describe the second case in literature of Merkel cell carcinoma of penis, a rare, very aggressive neuroendocrine tumor. Treatment is debatable in view of the fact that this kind of tumor has unpredictable biological behaviour; early regional lymph node involvement, early distant metastases and a high recurrence rate. Considering these facts, we used pre-operative lymphoscintigraphy, intra-operative lymph node mapping and sentinel node biopsy before performing a bilateral inguinal lymphadenectomy. All lymph nodes removed from each inguinal region were cancer-free. Although the patient had received a cycle of adjuvant chemotherapy, he developed inguinal recurrence and iliac metastasis.