Merkel-cell trabecular carcinoma of the skin has a prognosis poorer than expected for a small skin lesion. Surgery is central to actual treatment. A wide excision is indicated for localized disease. For selected cases we believe that an extensive resection of the draining lymphatics in continuity with the tumor should be performed. We have called this procedure "lymphangiectomy" in comparison to lymphadenectomy when the lymph nodes are removed. An early diagnosis and prompt treatment can contribute to improve the survival for this aggressive skin tumor.