Intracranial Spread of Merkel Cell Carcinoma to the Cerebellopontine Angle

Abstract

Background:

Merkel cell carcinoma (MCC) is a rare, highly malignant, and aggressive dermal neuroendocrine neoplasm that rarely metastasizes to the central nervous system.

Objective:

To review the current literature regarding treatment of neurometastatic MCC.

Methods:

A case of a 78-year-old male with intracranial extra-axial metastatic MCC involving the left cerebellopontine angle is presented.

Results:

A retrosigmoid craniectomy was performed with complete resection of the metastatic focus. Adjuvant treatment included whole-brain radation therapy followed by etoposide and carboplatin chemotherapy. Seven months postoperatively, the patient was free of metastatic disease.

Conclusion:

Surgical resection should be performed when feasible to prevent local recurrence. This may be followed by early adjuvant fractionated whole-brain radiotherapy and systemic chemotherapy; however, no clinical trials have been performed to demonstrate a survival benefit.