Unmasking the uncommon: Merkel cell carcinoma mimicking benign upper lip swelling in an elderly patient

Merkel cell carcinoma (MCC) is a rare neuroendocrine carcinoma with aggressive behavior that predominantly affects the sun-damaged skin of the head and neck regions, extremities, and trunk of white older individuals. We present a unique case of MCC presenting as painless upper lip swelling, initially mistaken for a benign lesion. Histopathological examination revealed characteristic features of MCC. Early diagnosis and intervention led to improved outcomes. This case emphasizes the importance of considering MCC in the differential diagnosis of seemingly innocuous cutaneous lesions. To the best of our knowledge, 24 cases of MCC of the lips have been reported to date in the English language literature, and this case is probably the first to be reported from the Middle East region.