How would you treat an upper extremity high grade neuroendocrine carcinoma s/p 6 cycles of cisplatin and etoposide followed by resection ypT0 ypN1?

I would be suspicious. I recently treated a patient with the same diagnosis who was diagnosed with cutaneous small cell carcinoma on an inguinal node excision, recurred during adjuvant chemo with inguinal, external iliac, and common iliac adenopathy. Path was reviewed and diagnosis changed to Merkel...

If I understand, this is a patient with a cutaneous T0N1 Merkel cell carcinoma of the upper extremity. First obtain PET-CT. Axillary dissection to resect gross disease. Postoperative RT to axilla and supraclav with concomitant weekly cisplatin 30 mg/M2. It's OK to follow with 4-6 cycles of adjuvant ...

I agree with @Dr. First Last that the diagnosis here is a bit vague. I would recommend having a secondary pathology review at a high-volume sarcoma center. Even between high-volume centers there can be some discordance. This could indeed be Merkel cell carcinoma, but the differential diagnosis inclu...