Identification of a Cervical Merkel Cell Carcinoma Using Intraoperative Near-Infrared Imaging

Merkel Cell Carcinoma is a rare and aggressive skin cancer. Treatment is based on staging and relies on either surgical or radiation therapy. For surgeons, the primary challenge is identifying the extent of disease and clinically relevant lymph nodes for accurate staging. Thus, our group has proposed using near-infrared (NIR) imaging during neck dissections to delineate the tumor borders and draw the attention of the surgeon to suspicious lymph nodes. Here, we present a case report detailing how intraoperative imaging of the neck demonstrated tumor fluorescence in Level 1 and 2 lymph nodes. NIR imaging also located an additional lymph node which showed evidence of microscopic disease. This case demonstrates the use of intraoperative NIR imaging as a useful adjunct to facilitate identification of surgical borders of a Merkel cell tumor in the neck. Enhanced visualization and additional visual information from imaging can provide a significant advantage in the resection of head and neck cancers