AWARENESS FOR MERKEL CELL CARCINOMA: CONSIDER IT

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 (diameter of half a centimetre), mobile, with well-defined edges, soft consistency and erythema. Palpation was painless and without node involvement. The patient had history of metastatic prostate adenocarcinoma. One week later, the lesion showed rapid growth (diameter of two centimetres) 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 to this type of tumour is crucial. A delay in diagnosis affects significantly the prognosis of the disease.