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A Journal on Ophthalmology
Minerva Oftalmologica 2013 September;55(3):69-73
Eyelid Merkel cell carcinoma: a case report
Ferrara M., Strianese D., Ruggiero P., Comune C., Tranfa F.
Dipartimento di Scienze Oftalmologiche Università degli Studi Di Napoli “Federico II” Napoli, Italia
Eyelid Merkel cell carcinoma (MCC) is a rare potentially fatal skin tumor affecting older mainly white peopleand younger immunosuppressed individuals. The overall incidence of MCC is estimated to be 0.44 per 100 000. This tumor is often associated with a rapid progression, regional nodal disease, and a high risk of distant metastases. The benign appearance of the tumor usually on exposed skin parts, contrasting with its extensive microscopic invasion, can delay timely diagnosis. Clinical features are a purple–red nodule of the eyelid, often causing ptosis. Macroscopical differential diagnosis should be made with a chalazion, dermal cyst, basal cell carcinoma, squamous cell carcinoma, keratoacanthomas, nodular angiosarcoma, amelanotic melanoma or a metastasis. We present the case of a 84-year-old female patient who developed a recurrence of an MCC of the lower eyelid after local excision. The recurrence was associated with extension to preauricular and neck lymph nodes. Confirming the features of malignancy and aggressiveness of the tumor. Eyelid Merkel cell carcinoma is a rare malignancy with uncertain prognosis. The treatment approaches found to be best are radical surgery of primary tumor, drainage of lymph node extension and possibly adjuvant loco-regional radiotherapy. This because MCC respond well to radiation therapy. While the experience with chemotherapy for disseminated MCC is still limited.