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Unique presentation of Merkel cell tumour affecting the hand
  1. Julia Tomtschik1,
  2. Keith Sweitzer2 and
  3. Derek Bell2
  1. 1School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
  2. 2Department of Surgery, Division of Plastic Surgery, University of Rochester Medical Center, Rochester, New York, USA
  1. Correspondence to Ms Julia Tomtschik; julia_tomtschik{at}


Merkel cell carcinoma (MCC) is a rare and highly aggressive skin cancer which most commonly occurs on the head and neck. A limited number of cases of MCC of the hand have been reported in the English literature. We describe a case of MCC of the hand in a man in his late 60s. The lesion presented on the dorsum of the left fifth digit, with metastasis to the left axillary lymph nodes. The primary lesion grew rapidly over a span of 3 months. The patient was treated with two courses of neoadjuvant nivolumab, amputation of the digit and left axillary lymph node resection followed by radiotherapy to the left hand and left axilla. He continues to follow-up for radiotherapy treatment 3 months postoperatively.

  • Dermatology
  • Skin cancer
  • Surgical oncology
  • Plastic and reconstructive surgery

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  • Contributors All authors contributed meaningfully towards the conception and design of the paper, drafting and revising the manuscript and approval of the final document. JT performed the literature review and reviewed the case. KS and DB cared for the study patient. KS obtained patient consent.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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

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