Merkel Cell Carcinoma of the Hand

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer, typically involving the head, neck, and rarely extremities. MCC of the hand is rare, and early diagnosis is critical to optimizing patient outcomes. We report a case of MCC of the hand in a 79-year-old woman with a 1-month history of a left-hand mass. A punch biopsy of the lesion confirmed the diagnosis of MCC. Treatment consisted of wide local excision with 1.5 cm margins, split-thickness skin grafting, a negative sentinel node biopsy, followed by a single treatment of adjuvant radiation therapy. This case emphasizes the importance of early detection of MCC in atypical locations and highlights the challenges in diagnosis and management. Early recognition and aggressive treatment of MCC is critical to improving patient outcomes. This case also discusses a change in adjuvant radiation therapy protocols for MCC.