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Merkel cell carcinoma; a rare, aggressive, cutaneous malignancy
  1. Joanne Manten1,
  2. Maartje Rijk2,
  3. Rene Jansen2
  1. 1
    Meander Medical Centre Amersfoort, Department of Geriatric Medicine, Utrechtseweg, PO Box 1502, Amersfoort, 3800 BM, Netherlands
  2. 2
    Meander Medical Centre, Department of Geriatric Medicine, Utrechtseweg, PO box 1502, Amersfoort, 3800 BM, Netherlands
  1. Joanne Manten, j.manten{at}

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An 87-year-old woman presented to our department with firm, shiny, flesh-colored, painless nodules locates on the face (Figure 1) and right upper eyelid (Figure 2).

Figure 1

rapidly growing localisation of Merkel Cell carcinoma on the forehead resembling a sebaceous cyst.

Figure 2

localisation on the upper eyelid of Merkel Cell Carcinoma resembling a chalazion.

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