Medically inoperable Merkel cell carcinoma of the head and neck treated with stereotactic body radiation therapy: a case report
Bibliographic record
Abstract
Merkel cell carcinoma (MCC) is a rare but aggressive neuroendocrine tumour of the skin. MCC is the second most common cause of death from non-melanoma skin cancer and the most aggressive cutaneous malignancy. An 88-year-old male presented with a large, bleeding skin tumour located on the right temple and pre-auricular region. A biopsy confirmed MCC; immunohistochemistry (IHC) was positive for synaptophysin and CK20. The patient was assessed by a head and neck surgical oncologist and not deemed to have operable disease due to medical co-morbidities and extent of disease. The patient underwent a single fraction of electron treatment, followed by stereotactic body radiation therapy (SBRT) to a total dose of 40 Gy in 5 fractions over 2 weeks. Bleeding stopped and the patient tolerated treatment well with no reported side effects other than fatigue. There was symptomatic improvement within 2 weeks and a complete clinical response within 4 weeks of treatment. There are limited data on the use of radiotherapy in unresected/ inoperable MCC. For elderly, medically frail patients who cannot undergo surgery, SBRT may be an option to alleviate symptoms and control the tumour in a relatively short number of treatments; further study is warranted.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".