Merkel cell cancer classification
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Classification
Histologically, MCC has been classified into three distinct subtypes:
- Trabecular: classic pattern, large-cell type, high density or granules on ultrasound examination.
- Intermediate: solid pattern (most common).
- Small cell: diffuse, few high density granules on ultrasound examination (second most common).
Staging
Stage | Primary Tumor | Lymph Node | Metastasis |
0 | In situ primary tumor | No regional lymph node metastasis | No distant metastasis |
IA | Less than or equal to 2 cm maximum tumor dimension | Nodes negative by pathologic exam | No distant metastasis |
IB | Less than or equal to 2 cm maximum tumor dimension | Nodes negative by clinical exam* (no pathologic node exam performed) | No distant metastasis |
IIA | Greater than 2 cm tumor dimension | Nodes negative by pathologic exam | No distant metastasis |
IIB | Greater than 2 cm tumor dimension | Nodes negative by clinical exam* (no pathologic node exam performed) | No distant metastasis |
IIC | Primary tumor invades bone, muscle, fascia, or cartilage | No regional lymph node metastasis | No distant metastasis |
IIIA | Any size tumor (includes invading tumors) | Micrometastasis** | No distant metastasis |
IIIB | Any size tumor (includes invading tumors) | "Macrometastasis*** -OR- In transit metastasis****" | No distant metastasis |
IV | Any size tumor (includes invading tumors) | Any lymph node metastasis | Metastasis beyond regional lymph nodes |