Abstract
A 58-year-old woman presented with a corneoconjunctival tumor, first diagnosed as a squamous neoplasia. An excisional biopsy was performed. Histopathology revealed signs of MCC, which is a rare malignant tumor of the skin. It can affect the eyelids and is a differential diagnose of recurrent chalazion. The patient had a history of multiple chalazia excision. MCC is known to be highly aggressive and tends to metastasize early to regional lymph nodes. It is believed to originate from Merkel cells, which have not been identified in the conjunctiva or cornea. However, the tumor may originate from integration of Merkel cell polyomavirus (MCPyV) in other epithelial cells. Metastatic compromise of the conjunctiva by this tumor has been reported as well. We herein report a case of both corneal and conjunctival involvement by a previously misdiagnosed MCC. A correct histopathological analysis, including immunohistochemistry techniques oriented by clinical suspicion, is crucial for the diagnosis. Prognosis of this tumor is known to be poor, that is the reason why an accurate diagnosis and an early referral to an oncologist are essential to a successful management of the disease.
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