Baseline ultrasound and FDG‐PET/CT imaging in Merkel cell carcinoma. Issue 5 (27th December 2022)

• Record Type: Journal Article
• Authors: Zijlker, Lisanne P.; Bakker, Max; van der Hiel, Bernies; Bruining, Annemarie; Klop, W. Martin C.; Zuur, Charlotte L.; Wouters, Michel W. J. M.; van Akkooi, Alexander C. J.
• Is Part Of: Journal of surgical oncology. Volume 127:Issue 5(2023)
• Page Start: 841
• Page End: 847
• Publication Date: 2022-12-27
• Subjects: baseline imaging -- FDG‐PET/CT -- Merkel cell carcinoma -- ultrasound; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.27193
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Background: Merkel cell carcinoma (MCC) is a cutaneous tumor with a high tendency to metastasize, and a significant proportion of patients have metastases at first presentation. This study aims to determine the value of baseline ultrasound (US) and 18 fluorodeoxyglucose‐positron emission tomography/computed tomography ( 18 FDG‐PET/CT) imaging in both patients with clinically localized MCC (Stage I/II) and patients who present with palpable lymph nodes (Stage III). Methods: This retrospective cohort included 135 MCC patients who underwent baseline US (with fine needle aspiration cytology (FNAC)) and/or FDG‐PET/CT imaging between 2015 and 2021. Results: Of the 104 patients with clinically localized disease, 48% were upstaged to Stage III and 3% to Stage IV by imaging or sentinel lymph node biopsy (SLNB). FDG‐PET/CT imaging identified regional metastases in 23%, while US with FNAC identified regional metastases in 19%. SLNB was performed in 56 patients, of whom 57% were upstaged to Stage III. Of the 31 patients who presented with palpable lymph nodes, 16% were upstaged to Stage IV by FDG‐PET/CT imaging. Conclusion: Baseline imaging frequently upstages Stage I/II MCC patients to Stage III, both by US and FDG‐PET/CT, Stage IV disease is rarely identified. Patients who present with palpable nodes are frequently upstaged to Stage IV by FDG‐PET/CT imaging.