the primary site is in the skin, it is referred to as a Merkel-cell carcinoma. Extrapulmonary small-cell carcinoma localized in the lymph nodes This is an extremely rare type of small cell, and there has been little information in the scientific community. It appears to occur in only one or more lymph nodes, and nowhere else in the body. Treatment is similar to small cell lung cancer, but survival rates are much higher than other small-cell carcinomas. Small-cell carcinoma of the prostate Small-cell carcinoma of the prostate (SCCP) is a rare form of prostate cancer (approx. 1% of PC). Due to the fact that there is little variation in prostate specific antigen levels, SCCP is normally diagnosed at an advanced stage, after metastasis. Symptomatic metastasis of SCCP to the brain is rare, and carries a poor prognosis. Genetics TP53 is mutated in 70 to 90% of SCLCs. RB1 and the retinoblastoma pathway are inactivated in most SCLCs. PTEN is mutated in 2 to 10%. MYC amplifications and amplification of MYC family members are found in 30% of SCLCs. Loss of heterozygocity on chromosome arm 3p is found in more than 80% of SCLCs, including the loss of FHIT. One hundred translocations have so far been reported in SCLCs (see the "Mitelman Database" and the Atlas of Genetics and Cytogenetics in Oncology and Haematology,). Diagnosis When Localized: the cancer is confined to the lung (aka: limited stage SCLC). Regional: the cancer has spread to lymph nodes (or glands) within the chest (between limited and extensive stage SCLC). Lymph nodes act as a filtering system outside the lung, collecting cancer cells that are beginning to migrate out of the lung. Distant: the cancer has spread (or metastasized) to other parts of the body (aka: extensive stage SCLC). At the time of diagnosis, 60–70% of people already have metastases. Small-cell carcinoma is an undifferentiated neoplasm composed of primitive-appearing cells. As the name implies, the cells in small-cell carcinomas are smaller than normal cells, and barely have room for any cytoplasm. Some researchers identify this as a failure in the mechanism that controls the size of the cells. Treatment Small-cell lung cancer is most commonly treated with a combination of two drugs, which is more effective than one drug alone. Chemotherapy Cisplatin and etoposide, Carboplatin and etoposide. Cisplatin-resistance The drug paclitaxel may be useful in the treatment of cisplatin-resistant cancer. About 68.1% of cisplatin-resistant