Clinical and radiographic screening to exclude metastasis from primary noncutaneous small cell carcinoma (e.g., SCLC) and other IHC stains for MCC (e.g., neurofilament, chromogranin A, synaptophysin, and Merkel cell polyomavirus large T antigen) can be obtained if the diagnosis remains in question [7, 10, 15, 17]. This evidence concerns the gene SYP and Merkel cell skin cancer.