Merkel Cell Carcinoma: An Updated Review Focused on Bone and Bone Marrow Metastases

• DOI: 10.20944/preprints202504.0427.v1
• Publication Date: 2025-04-10T00:46:11Z
• Authors: Biagio Scotti; Elisabetta Broseg...; Costantino Ricci; Barbara Corti; Cosimo Misciali; Carlotta Baraldi; Sabina Vaccari; Martina Lambertini; Federico Venturi; Elisabetta Magnat...; Aurora Alessandrini; Tiziano Ferrari; Massimo Lepri; Gabriele Argenziano; Barbara Melotti; Elena Campione; Davide Campana; Manuela Ferracin; Emi Dika

Background/objectives: Despite advancements in early diagnosis and clinical practices guided by standardized care protocols, Merkel cell carcinoma (MCC) is still marked an unfavorable prognosis with a 5-year relative survival rate of 65%. Indeed, regional nodal metastases affect 40-50% MCC patients, while approximately 33% experience distant dissemination. Among these, bone marrow are particularly notable, although the characteristics implications this metastatic disease remain poorly understood. Methods: A comprehensive review was conducted using Medline database (via PubMed) up to January 2024. The search strategy included string “(Merkel AND (bone OR marrow))”. Results: total 1,133 (69.3% male 30.7% female) patients diagnosed advanced were collected. median (IQR) age at 67.5 (12.65) years old. 201 (20.8%) cases and/or identified linked primary known 75.7% cases. Bone (BMs) appear as third most common site, following liver (2nd) lymph nodes (1st). They show mixed biological radiological behavior, preference for axial skeleton over appendicular one. Addressing disease, neurological symptoms documented, whereas involvement leukemic spread seemed be primarily related immunosuppression. Multimodal treatment including platinum-based chemotherapy radiotherapy represented approach effective management. Conclusions: pattern differ among studies, bones resulting site spread. Excluding head neck MCC, which seems more regularly associated metastases, relationship between tumor development or appears inconsistent. Overall, BMs mostly correlated stages poorer outcomes, OS 8 months (range 12.75-4). integration international guidelines alongside ongoing findings from trials will contribute improve systemic control enhance patient care.