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Metastatic Merkel cell carcinoma presenting as an orbital mass
William D Wagner1, Derek W Lahm2, Atman Dave3
1Stanley Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Orbit (Amsterdam, Netherlands)
|August 3, 2022
Summary
This case report details a rare instance of Merkel cell carcinoma (MCC) metastasizing to the orbit without a known primary tumor. It highlights the aggressive nature of this rare skin cancer.
Area of Science:
- Oncology
- Dermatology
- Ophthalmology
Background:
- Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with a high risk of metastasis.
- Orbital metastasis from MCC is exceptionally uncommon, with few documented cases.
Observation:
- A 67-year-old female presented with orbital symptoms including pain, redness, and diplopia.
- Magnetic resonance imaging (MRI) revealed an orbital mass, later diagnosed as MCC via biopsy.
- The patient had no identifiable primary head or neck lesion or prior history of MCC.
Findings:
- Positron emission tomography (PET) scan identified widespread metastatic disease, including subcutaneous lesions on the lower extremity and multiple osseous lesions.
- This represents the third reported case of MCC with orbital metastasis and the first with no known primary tumor or prior MCC diagnosis.
Implications:
- This case underscores the potential for MCC to present with distant metastasis, even in the absence of a detectable primary site.
- It emphasizes the importance of considering rare metastatic patterns in the differential diagnosis of orbital masses.
- The aggressive nature and unusual presentation of MCC necessitate ongoing research into diagnostic and therapeutic strategies.
