Merkel Cell Carcinoma of the Eyelid: A Case Report

Abstract

A 22-year-old woman who presented with a tumour of the upper eyelid with clinical, histological, immunohistochemical and ultrastructural features of a Merkel cell carcinoma is reported. This is a unique case of Merkel cell carcinoma in such a young patient. This neuroendocrine tumour is typically found in the elderly. It can grow rapidly, has the potential for local recurrence and early metastatic spread. The authors recommend wide resection of the primary site, which proved effective in this case.

Merkel Cell Carcinoma

“…The tumor cells express CAM 5.2 and more specifically cytokeratin (CK) 20, often as a paranuclear dot (Fig 3). [54][55][56][57] In contrast, neurofilament protein, again presenting as a paranuclear dot, is commonly present in Merkel cell tumor but is often absent in bronchial small-cell carcinoma. Similarly, thyroid transcription factor, a homeodomain-containing nuclear transcription factor, is present in small-cell carcinoma of bronchial derivation but is not present in Merkel cell tumor.…”

Eyelid metastases indicating neuroendocrine carcinoma of unknown origin

“…3 Malignant lesions should also be considered including basal cell carcinoma, squamous cell carcinoma, melanoma, sebaceous cell carcinoma, and primary neuroendocrine of the skin or Merkel cell carcinoma. 1,2,4 In our patient, the histologic differential diagnosis consisted of poorly differentiated primary eccrine carcinoma, metastatic poorly differentiated carcinoma, poorly metastatic carcinoid tumour, and Merkel cell carcinoma. 4,5 Immunohistochemical analyses were useful in this case and Merkel cell carcinoma was unlikely because tumour cells did not express cytokeratine 20.…”

“…1,2,4 In our patient, the histologic differential diagnosis consisted of poorly differentiated primary eccrine carcinoma, metastatic poorly differentiated carcinoma, poorly metastatic carcinoid tumour, and Merkel cell carcinoma. 4,5 Immunohistochemical analyses were useful in this case and Merkel cell carcinoma was unlikely because tumour cells did not express cytokeratine 20. 6 In conclusion, diagnosis of eyelid metastases requires a high index of suspicion in every patient, even those with no history of cancer, since it may indicate the condition and therefore allows rapid instauration of treatment.…”