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A Simple and Sensitive Method for the In Vivo Visualization of Merkel Cell Tumors and Their Metastases

Dirk J. Kwekkeboom, MD; Anneke M. Hoff, MD; Steven W. J. Lamberts, MD; H. Yoe Oei, MD; Eric P. Krenning, MD

Arch Dermatol. 1992;128(6):818-821.

Abstract
• Background.—
Trabecular carcinomas of the skin, or Merkel cell tumors, are aggressive neoplasms that tend to occur in sun-exposed skin. These tumors frequently metastasize and, despite therapy, the number of disease-related deaths is high. Ultrastructurally and immunocytochemically, the majority of these tumors have neuroendocrine characteristics. Recently, we described the in vivo visualization of various neuroendocrine tumors after injection of a radiolabeled somatostatin analogue (octreotide). In this study, we report the results of scintigraphy with radioactive-labeled somatostatin analogues in five patients with Merkel cell tumors.

Observations.—
In all four patients in whom tumor was detected using computed tomographic scanning and ultrasound, the tumor sites were also demonstrated on octreotide scintigrams. In one patient, a tumor with a diameter that was smaller than 0.5 cm could not be detected with octreotide scintigraphy, computed tomography, or ultrasound. Using octreotide scintigraphy we found presumed tumor spots in two patients that were not evident when other techniques were used.

Conclusions.—
Octreotide scintigraphy has an equal or even greater sensitivity than computed tomography and ultrasound for detecting Merkel cell tumors and their metastases. Establishing the spread of the disease in this way may ensure an optimal choice of treatment in patients with this type of tumor.

(Arch Dermatol. 1992;128:818-821)

Author Affiliations
From the Departments of Medicine (Drs Kwekkeboom, Lamberts, and Krenning) and Nuclear Medicine (Drs Kwekkeboom, Lamberts, Oei, and Krenning), University Hospital Dijkzigt (Drs Kwekkeboom, Lamberts, Oei, and Krenning), and the Department of Medicine, Dr Daniel den Hoed Kliniek (Dr Hoff), Rotterdam, The Netherlands.

Footnotes
Accepted for publication October 1, 1991.

Reprints not available.

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