Diagnostic Yield of Staging Brain MRI is Low in Merkel Cell Carcinoma: A Single-Institution Cohort Study

Merkelcell.org Summary

Merkel cell carcinoma, fortunately, rarely spreads to the brain, unlike several other types of cancer including melanoma. This study from Dr. David Miller’s team at Massachusetts General Hospital shows that unless there is some specific reason to suspect it (bad headaches, alteration in ability to move properly, etc.) it is not necessary to routinely obtain a brain scan at the time of initial MCC diagnosis. The recommended scan at time of MCC diagnosis is a PET-CT scan, and these new data support the emerging consensus that an additional scan of the brain should not be routinely ordered.

Abstract

Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine cancer which seldom presents with brain metastasis. Here we present the diagnostic yield of brain magnetic resonance imaging (MRI) at presentation (<90 days from pathological diagnosis) from a cohort of 77 cases diagnosed between 2016 and 2020 available from the Mass General Brigham (MGB) medical record. Our data demonstrates that staging brain MRI rarely yields positive findings, suggesting that routine brain imaging, particularly for the majority of patients who present without neurologic symptoms, may not be indicated.