Metastases of the Brain and the Adrenal Glands - A Rare Case of Merkel Cell Carcinoma

Merkel cell carcinoma is a highly aggressive but rare malignancy of the skin. At the time of initial diagnosis, 30% of the patients already have loco-regional lymph node metastases. Distant metastases are commonly found in other lymph nodes stations, the skin, abdominal organs and bones. In distant metastases the 5-year overall survival (OS) is reduced to 18%. We report on a patient with Merkel cell carcinoma who developed distant metastases of the brain and the adrenal glands one year after initial diagnosis. Both are rare locations. Radiotherapy, radiosurgery and immunotherapy with Avelumab were applied, showing good response especially for the brain metastases. However fast progression of the metastases in the adrenal glands finally led to readjustment to a palliative platin-based chemotherapy.