BMJ Case Reports 2018; doi:10.1136/bcr-2018-224924
  • Rare disease

Metastatic Merkel-cell carcinoma: the dawn of a new era

  1. Derek G Power2
  1. 1Department of Medical Oncology, Mercy University Hospital, Cork, Ireland
  2. 2Department of Medical Oncology, Cork University Hospital Group, Cork, Ireland
  1. Correspondence to Dr Timothy O’Brien, timothy.n.obrien{at}
  • Accepted 26 June 2018
  • Published 11 July 2018


Merkel-cell carcinoma (MCC) is a rare but aggressive cutaneous malignancy arising most often in sun-exposed Caucasians who are immunosuppressed or the elderly. Patients with metastatic disease treated with chemotherapy have a median progression-free survival of just 3 months. This report describes a 58-year-old man with a background history of psoriasis treated with immunosuppressive therapy and subsequently diagnosed with metastatic MCC. Chemotherapy produced a partial response. Then, a novel immunotherapy agent, pembrolizumab, induced a complete response maintained for at least 19 months. Quality of life was unaffected, and toxicity from immunotherapy was minimal. At the time of writing, there was no clinical or radiological evidence of recurrence and treatment is ongoing.


  • Contributors TO’B wrote the original manuscript. DGP provided feedback and edited the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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