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The nodules resembled a sebaceous cyst e.g. chalazion. However, history revealed rapid growth.
Laboratory tests revealed a high ESR (85 mm/h), normocytic anemia (4.8 mmol/l) and elevated LDH (1877 IU/l). Computer tomography showed intrapulmonal, mediastinal, axillary nodal and pelvic metastasis. Biopsy diagnosed Merkel cell carcinoma (MCC). Our patient died four weeks later.
MCC is a rare, aggressive cutaneous malignancy. Early diagnosis is often missed because of its inconspicuous aspect. One-third to half of the patients develop extended metastatic disease within a year. Due to its rarity, there is limited information for the management of MMC.
Competing interests: none.
Patient consent: Patient/guardian consent was obtained for publication