Study explores parotid involvement in Merkel cell carcinoma

   Researchers at the University of Alabama at Birmingham sought to determine the prognostic implication of parotid gland involvement in Merkel cell carcinoma (MCC). They presented their study at Triological Society 2013, held April 2013 in Orlando.

   They reviewed a series of 14 patients (13 males, ages 62-87) who underwent parotidectomy for the diagnosis of MCC between 2002 and 2010, including a mean followup of 12.4 months. There were 10 primary skin lesions of the head and neck (H&N) while four patients presented with parotid masses and unknown primary lesions. Additionally, 13 patients had parotid involvement and one underwent parotidectomy with negative pathology. All patients received adjuvant radiation (with the except of one who died postoperatively due to other comorbidities). No patient received adjuvant chemotherapy. 

    According to the researchers, 13 patients (92.9%) had positive parotid disease at the time of surgery either by direct extension into the gland or positive intraparotid lymph nodes. Further, 10 patients also received neck dissections, six of whom (60%) had cervical lymph node metastasis on pathologic examination. At last followup, 11 of 13 evaluable patients had died; the single patient without positive parotid disease remains alive (two patients were lost to followup). The investigators noted that patients with parotid and neck involvement had an average time to death of 17.4 months. 

   The University of Alabama findings are consistent with other reports demonstrating decreased survival in patients with MCC of the H&N with nodal metastases. "In this series, parotid involvement predicted worse survival than reported with cervical node involvement," the researchers concluded.