A Rare Case of Merkel Cell Carcinoma of the Eyelid

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine malignancy of the skin, with a higher mortality rate than melanoma.This case report describes an 87-year-old woman presenting with a violaceous, nodular, exophytic mass on the upper eyelid.Histopathological examination revealed a poorly differentiated neoplasm with characteristic "salt-and-pepper" chromatin and a mitotic index of seven mitotic figures per eight high-power fields.Immunohistochemical analysis showed positive staining for CK20, Chromogranin and Synaptophysin, confirming the diagnosis of Merkel cell carcinoma.The tumor was staged as T2N0M0, with no evidence of lymph node or distant metastasis.This report highlights the diagnostic and management challenges associated with MCC, particularly in the eyelid, an uncommon but critical site.Early detection, histopathological evaluation and comprehensive staging, including sentinel lymph node biopsy, are essential for optimizing outcomes.Adjuvant radiotherapy and careful follow-up are recommended to minimize recurrence and address metastatic risk.This case emphasizes the importance of multidisciplinary care in managing this rare yet aggressive cancer.