Merkel cell carcinoma associated with HIV: review of 14 patients

Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine tumor that has a high propensity for early metastases and high rates of local recurrence after surgical excision. Most cases of MCC are associated with human polyomavirus (HPyV) infection, and immunosuppression is a known risk factor [1,2]. Indeed, the risk of developing MCC is 13 times greater in HIV patients compared with the general population [1–3]. We evaluated the demographic and clinical aspects of HIV-associated MCC (HIV-MCC) in three patients seen at a tertiary care specialty hospital and 11 other patients previously described in the medical literature, and compared these with the clinical aspects of MCC in immunocompetent patients (IC-MCC). All methods were previously approved by the Institutional Review Board of the Fred Hutchinson Cancer Research Center (FHCRC). A total of 14 HIV-MCC patients were identified for review, including 11 patients from the English language literature (references [4–14]) and three patients from the FHCRC database ‘Repository of Data and Specimens for MCC ’ (W10, W137, and W162). We analyzed the average age at diagnosis, lesion location, duration of HIV diagnosis prior to MCC diagnosis, the relationship between CD4 cell counts and MCC diagnosis, and the average duration o