Awareness for Merkel Cell Carcinoma: Consider it

Abstract

We present a case of a 71-year-old Caucasian male complaining of left lateral lower eyelid swelling after an insect sting sensation. Physical examination showed an oval shaped lesion (half a centimetre diameter), mobile, with well-defined edges, soft consistency, and erythema. Palpation was painless and without lymph node involvement. The patient had a history of metastatic prostate adenocarcinoma. One week later, the lesion showed rapid growth (two centimetres diameter) with central ulceration. Incisional biopsy was made. Immunohistochemistry findings were suggestive of a primary neuroendocrine carcinoma: Merkel Cell Carcinoma. The patient underwent surgery with wide local excision, regional lymphadenectomy, and eyelid reconstruction. Awareness of this type of tumor is crucial. A delay in diagnosis affects the prognosis of the disease significantly.

Keywords

• merkel cell carcinoma
• eyelid neoplasms
• merkel cells
• ophthalmology
• skin neoplasms.