Merkel cell carcinoma (MCC) is an aggressive, uncommon, neuroendocrine malignant neoplasm of the skin. There have been rare reports of MCC presenting as lymphadenopathy with no apparent cutaneous primary lesion.1 This may result from complete regression of a primary cutaneous MCC. Histologically, nodal MCC must be differentiated from other similar neuroendocrine malignant neoplasms.2 Herein, we describe 2 additional patients diagnosed as having MCC presenting only with lymphadenopathy.