What should you know about merkel cell melanoma?

Merkel cell carcinoma often appears as a firm, shiny, painless, skin-coloured, red, or violet lump. It can grow noticeably over a short period and may occur on sun-exposed skin, although it is not limited to one body area. The name is sometimes confused with melanoma, but these are different skin cancers. A biopsy is needed to identify the tumour, and examination of nearby lymph nodes and scans may be used to understand its extent. General information about [Melanoma](/conditions/melanoma/) can help explain how skin cancers differ, but it does not replace a pathology report.

Because this cancer can spread beyond the original skin site, the care plan may involve dermatology, surgery, oncology, and radiation specialists.

Arrange prompt review for a new or changing lump, especially one that enlarges, bleeds, crusts, or remains firm. Do not pick at it or try to remove it at home. A clinician may recommend [Surgical Excision](/treatments/surgical-dermatology/excisional-surgery/) or broader [Skin Cancer Surgery](/treatments/surgical-dermatology/skin-cancer-surgery/) after biopsy planning. A [Sentinel Lymph Node Biopsy](/treatments/diagnostics-and-staging/sentinel-lymph-node-biopsy/) may be discussed to assess nearby lymphatic drainage. Depending on staging, treatment can also include [Immunotherapy](/treatments/systemic-therapy/immunotherapy/) or other cancer-directed care.

Seek urgent medical advice for rapid growth, uncontrolled bleeding, severe pain, spreading redness, or a new lump near the original lesion. New neurological symptoms such as severe headache, weakness, confusion, seizures, or changes in vision require emergency assessment because they may indicate serious complications, including possible [Brain Metastases](/conditions/brain-metastases/).

Ask what the biopsy shows, whether the margins are clear, whether lymph nodes need assessment, and which scans are appropriate. Clarify the proposed sequence of surgery, additional treatment, and follow-up. Ask which changes between visits should trigger an earlier review and how your team will coordinate surveillance after treatment.