14th July 2026

Prognosis

• Favourable prognostic factors include female gender, age <50, tumour size ≤  2cm, local disease, presence of Merkel cell polyomavirus or increased viral abundance. 
• Poor prognostic factors include those who are immunosuppressed and those with nodal involvement. Histology features that would suggest poor prognosis include tumour size ≥ 5mm, diffuse growth pattern and high mitotic rate.

Management

Dependent on the stage of the tumour, a multidisciplinary approach is needed.

Early aggressive treatment is needed. 

Early stage MCC: surgical excision with wide resection margins followed by sentinel lymph node biopsy and postoperative radiotherapy

Localised MCC: surgical excision followed by radiotherapy

Advanced/metastatic disease: radiotherapy, chemotherapy, immunotherapy +/- molecular-targeted therapy.

References

• https://bestpractice.bmj.com/topics/en-gb/269/differentials#collapseDiff-47fe7fd8-09aa-404f-806a-5a4954c1a525
• https://dermnetnz.org/topics/merkel-cell-carcinoma