Abstract ID: 26-345
Eyelid Merkel Cell Carcinoma: Presentation, Multidisciplinary Management, and Clinical Outcomes in Three Cases
Author: Armaan Jaffer Base Hospital / Institution: Faculty of Health Sciences, Queen’s University
Presentation Type: ePoster Presentation
Purpose
Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer. Eyelid involvement accounts for 5–10% of cases and is often misdiagnosed. We present three such cases illustrating diagnosis, management, and outcomes.
Methods
Retrospective review of three consecutive eyelid MCC patients at academic centres. Presentation, histopathology, staging, treatment, and outcomes were extracted from records.
Results
Patient 1, a 78-year-old male, presented with a 1×0.5 cm upper-eyelid lesion. Marginal biopsy confirmed MCC (cT1cN0M0, Stage I). He underwent wide local excision with flap-graft reconstruction. No recurrence was identified at 8-year follow-up. Patient 2, a 68-year-old male, presented with a 1.4 cm multicystic upper-eyelid lesion. Shave biopsy confirmed MCC. He underwent wide excision with tarsal/hard-palate reconstruction and concurrent parotidectomy/sentinel-node biopsy. The primary tumour showed lymphovascular invasion; 3/8 cervical/parotid nodes were positive (T4N1aM0, Stage III). Adjuvant radiotherapy and 12 cycles of nivolumab followed. No recurrence was identified; radiation-related complications required staged reconstruction and tarsorrhaphy. Patient 3, an 82-year-old male on dialysis, presented with a 3.5 cm upper-eyelid lesion and negative PET-CT (cT2cN0M0, Stage IIA). Wide excisional biopsy confirmed MCC. Hospitalisation due to hip fracture and other co-morbidities delayed follow-up. Locoregional recurrence to nasal wall/parotid required exenteration, parotidectomy, neck dissection, and radiotherapy. He died 18 months later.
Conclusion
Eyelid MCC demands early multidisciplinary care. Outcomes ranged from durable cure to locoregional recurrence and death when follow-up lapsed. Adjuvant radiotherapy and checkpoint inhibition control advanced disease. Radiation-related complications often require staged oculoplastic care.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Mahraz | Parvand | Department of Ophthalmology and Visual Sciences, University of British Columbia |
| Oleksandr | Butskiy | Department of Otolaryngology, Head and Neck Surgery, University of British Columbia |
| Ananta | Gurung | Department of Pathology and Laboratory Medicine, University of British Columbia |
| Mannat | Kaur | Bascom Palmer Eye Institute |
| Sara | Wester | Bascom Palmer Eye Institute |
| Femida | Kherani | Department of Ophthalmology and Visual Sciences, University of British Columbia |