An Unusual Clinical Presentation of Merkel Cell Carcinoma : A Case Report

الملخص EN

Introduction.

Merkel cell carcinoma is a rare, aggressive neuroendocrine cell carcinoma arising in the sun-exposed skin of elderly patients.

Most of these tumors are located in the dermis.

An unusual clinical presentation of such a tumor in the subcutis, if not biopsied, may be easily mistaken as a benign lesion.

Case Presentation.

An 83-year-old white woman presented with a several-month history of a painless 7 mm subcutaneous mass that was initially thought to be a lipoma.

A conservative follow-up was planned.

At the insistence of the patient, an excisional biopsy of the mass was performed revealing a subcutaneous Merkel cell carcinoma.

The tumor cells stained positively for CK 20, chromogranin, and synaptophysin.

No other primary or metastatic tumors found after a thorough work-up.

The patient was treated with local irradiation.

She remains disease free at her six-month follow-up visit.

Conclusion.

When a new growth is encountered in the sun-exposed skin of elderly patients, a biopsy is warranted even if the lesion clinically appears benign.