Can Females Get Merkel Cell Carcinoma?
Yes, females can definitely get Merkel cell carcinoma (MCC), although it is more common in older white men. 1
Epidemiology and Risk Factors
Merkel cell carcinoma affects both males and females, with the following characteristics:
- More common in males than females, but both sexes can develop the disease
- Predominantly affects older individuals (≥65 years of age)
- Occurs primarily in Caucasians (≥95% of cases)
- Risk factors that apply to both sexes include:
- Extensive sun exposure (major risk factor)
- Advanced age (>90% of patients are over 50 years, >76% are ≥65 years)
- Immunosuppression (organ transplants, lymphoproliferative malignancies, HIV infection)
- Merkel cell polyomavirus (MCPyV) infection (detected in 43-100% of tumors)
Clinical Presentation
MCC presents similarly in both males and females:
- Typically appears as a rapidly growing, asymptomatic lesion
- Most commonly occurs on sun-exposed areas (81% of cases)
- Head and neck are common locations (29-48% of all primary MCCs)
- Appears as a red nodule or plaque with fast growth
- Rarely clinically suspected due to lack of distinguishing features
Diagnosis
The diagnostic approach is identical for both sexes:
- Complete examination of skin and lymph nodes
- Biopsy of suspicious lesion
- Histopathologic examination showing small-cell neuroendocrine appearance
- Immunohistochemistry showing CK20 positivity and TTF-1 negativity
- Imaging studies to rule out regional and distant metastases
Treatment Considerations
Treatment protocols do not differ based on sex:
For localized disease:
- Surgical excision with postoperative margin assessment
- Sentinel lymph node biopsy
- Adjuvant radiation therapy
For advanced disease:
- Immunotherapy with anti-PD-(L)1 antibodies as first-line systemic treatment
- Chemotherapy for patients who fail to respond to immunotherapy
Prognosis
MCC is aggressive in both males and females:
- High mortality rate exceeding that of melanoma
- 5-year overall survival rates range from 30% to 64%
- Recurrence develops in 25-50% of all cases
- Local recurrence in 25-30% of cases
- Regional disease in 52-59% of cases
- Distant metastatic disease in 34-36% of cases
Important Considerations
- Early detection is crucial regardless of sex
- Regular skin examinations are recommended for high-risk individuals
- Immunosuppressed patients of both sexes require closer monitoring due to higher risk
- Expeditious initiation of treatment is recommended for all patients
MCC is a rare but aggressive skin cancer that can affect both males and females, with a predilection for older, fair-skinned individuals with significant sun exposure history.