We report the case of a 73-year-old female patient who came to the clinic with a tumour of the border and a narrower vertical extension of 2.5 months duration, painless, solid, reddish-brown ulcer with a superficial mesh.
There were no regional lymph nodes.
The tumor was excised and the defect was repaired using the Cutler Beard technique with a full-thickness flap of the lower eyelid 5 mm below and parallel to the free reconstruction margin.
At six weeks, the flap was implanted to remake the eyelids, remaining at three months as shown in Figure 3.
The histopathological study revealed a densely cellular tumor with a trabecular growth pattern, composed of medium-sized round cells with scarce cytoplasm and large nucleus with features of small necrosis.
An immunohistochemical study was performed giving negative reactivity against common leukocyte antigen and HMB45 and frankly positive against chromogranin, confirming the diagnosis of malignant Merkel cell carcinoma.
The extension study was negative.
In the three and a half years of follow-up, there were no local recurrences or metastases.
