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Tests and diagnosis
By Mayo Clinic staffDiagnosis of Merkel cell carcinoma involves the following:
- Physical exam. Examining unusual moles, freckles, pigmented spots and other growths on your skin is the first step your doctor will likely take in making a diagnosis. A careful physical exam is important, because it's difficult to distinguish Merkel cell carcinoma from other skin cancers, including basal cell carcinoma. The nodule on your skin may also resemble other skin growths or even harmless cysts.
- Biopsy. After removing the tumor or a sample of the tumor from your skin, your doctor treats the cells with a special stain for viewing under the microscope.
Determining the extent
Your doctor may use the following tests to help determine whether the cancer has spread beyond your skin:
- Sentinel node biopsy. When cancer cells spread, they often travel first to your lymph nodes. Lymph nodes are small, rounded structures that filter foreign particles from lymph, a tissue-cleansing fluid in your body. This procedure involves injecting a dye near the skin tumor. The dye then flows through the lymphatic system to your lymph nodes. The first lymph node that receives the dye is called the sentinel node. Your doctor removes this lymph node and looks for cancerous cells under a microscope.
- Other diagnostic tests. Imaging tests, such as X-ray or a computerized tomography (CT) scan, provide pictures of your body organs and structures. You'll likely have a chest X-ray and a CT scan of your chest and abdomen to help your doctor determine whether the cancer has spread to other organs. Your doctor may also consider other imaging tests such as a positron emission tomography (PET) scan or an octreotide scan — a test that uses a radioactively tagged hormone to check for the spread of Merkel cell carcinoma.
