Case ReportCase series: Merkel cell carcinoma of the eyelid
Section snippets
Case 1
A 71-year-old female, with no history of cancer, was referred for a rapidly growing “chalazion” that had recurred shortly after resection a month earlier. A 1.0 × 1.5 cm nodular, violaceous, telangiectatic lesion was noted on the temporal left upper lid margin (Fig. 1A). Histopathology confirmed MCC (Figs. 2A and 2B; Table 1). Metastatic work-up showed negative results. The patient underwent tumour resection with negative surgical margins and eyelid reconstruction (Fig. 1B). Six months later,
Discussion
The reported annual incidence of eyelid malignancies in the United States is 15.7 per 100,000 individuals,5 and MCCs account for a very small proportion of these.5, 6, 7 Although rare, these tumours are notorious for their distinctively rapid progression, high rate of recurrence after surgical resection, and early locoregional and metastatic spread.2,8
MCCs usually present in the upper eyelid as painless, solitary, multilobulated, violaceous nodules near the lid margin.3, 9 Involvement of the
Conclusions
We report 3 new cases of MCC of the eyelid—a very rare neuroendocrine tumour associated with poor prognosis, in part due to its often-delayed diagnosis. MCC commonly mimics benign and other malignant lesions, and recognition of MCC based on clinical grounds alone is difficult. Immunohistochemistry with positivity for CK20, expression of neuroendocrine markers, and negativity for thyroid transcription factor-1 allows its differentiation from its histologic imitators.
Disclosure
The authors have no proprietary or commercial interest in any materials discussed in this article.
Acknowledgements
The authors wish to thank Mariana Anunciação Saulle and Marilia Pereira Pimentel Fernandes for providing information on 2 of the 3 presented cases.
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Cited by (2)
Merkel cell carcinoma of the eyelid: A review
2019, Survey of OphthalmologyCitation Excerpt :Although the face is often affected, eyelid tumors represent only 2.5% of cases.74 To date, there have been approximately 200 cases of eyelid MCC reported, the features of which are summarized in Table 1.5–7,10,12,14–18,20,21,25–27,30,32–34,36,38,40,44,46–50,52,53,58,66,68–71,75,77,81–83,86,88,90,92–95,97,98,100,101,103–107,109–112,116–118,120–122,124,125,128–130,133,134,136,137,140,141 Although the pathogenesis of MCC is incompletely understood, the Merkel cell polyomavirus (MCPyV) plays a major role, along with UV exposure and immunosuppression.
New perspectives in Merkel cell carcinoma
2019, Current Opinion in Oncology