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Lee, Kim, and Roh: A Case of Localized Merkel Cell Carcinoma on the Upper Eyelid
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(6): 856-860.

Published online: 16 June 2012

DOI: https://doi.org/10.3341/jkos.2012.53.6.856

A Case of Localized Merkel Cell Carcinoma on the Upper Eyelid

Woo Seok Lee, MD, Sang Won Kim, MD, Joo Heon Roh, MD, PhD

Sungmo Eye Hospital, Busan, Korea.

Address reprint requests to Joo Heon Roh, MD, PhD. Sungmo Eye Hostpital, #409-1 Haeun-daero, Haeundae-gu, Busan 612-823, Korea. Tel: 82-51-743-0775, Fax: 82-51-743-0776, rhoahn@yahoo.co.kr

Received 8 June 2011       Accepted 18 April 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report a case of Merkel cell carcinoma on the left upper eyelid without metastasis and its immunohistochemical features. The carcinoma was successfully treated with excisional surgery and prophylactic radiation therapy.

Case summary

A 76-year-old woman presented to the hospital complaining of a 0.6 × 0.9-cm-sized painless and purplish-red colored mass that had grown rapidly on her left upper eyelid margin over the previous two months. An excisional biopsy was performed. On immunohistochemical examination of the lesion, the tumor cells expressed immunoreactivity for synaptophysin and were negative for LAC and cytokeratin, confirming the diagnosis of Merkel cell carcinoma. Additional surgery was performed because the surgical margins were positive. No other primary or metastatic lesions were found. The patient was treated with local prophylactic irradiation and remained disease-free at her 10-month follow-up visit.

Keywords: Eyelid mass, Immunohistochemical study, Merkel cell carcinoma, Neuroendocrine tumor, Synaptophysin

Figures and Tables

Figure 1
The lesion of the eyelid was nodular, nontender, and had relatively well-defined margins, measuring about 0.9 × 1.3 cm. It was fixed to tarsus and purplish-red in color. The overlying skin was intact with telangiectasia.
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Figure 2
(A) The tumor cells show uniform size with a round to oval nucleus and scanty cytoplasm. Arrow indicates vascular invasion (H&E stain, ×200). (B) The blue tumor cells infiltrate into the hair follicle. Arrow indicates hair follicle (H&E stain, ×100).
jkos-53-856-g002
Figure 3
Immunohistochemistry for synaptophysin indicating neuroendodermal origin, show brown positive staining on the tumors (×100).
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Figure 4
Immunohistochemistry for leukocyte common antigen shows negative (×100).
jkos-53-856-g004
Figure 5
Tumor cells are negative for cytokeratin (×100).
jkos-53-856-g005
Figure 6
Eight-month postoperative view. Functionally and cosmetically satisfactory results were obtained without any recurrence.
jkos-53-856-g006

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