REPORT OF A CASE
An 88-year-old white man presented with a 1-month history of an asymptomatic, rapidly enlarging nodule on his right cheek.The physical examination revealed a 2-cm firm, pink-to-red, lobulated tumor with a slightly yellow center on the right cheek (Figs 1 and 2). Palpable cervical lymphadenopathy was present on the right side. The remainder of the physical examination was unremarkable.A biopsy specimen was obtained for routine light microscopy (Figs 3 and 4). In addition, special immunocytochemical staining techniques were performed.What is your diagnosis?
Merkel cell carcinoma, with presumed metastasis to regional lymph nodes.
HISTOPATHOLOGIC FINDINGS AND CLINICAL COURSE
Routine hematoxylin-eosin-stained sections showed the neoplasm to be nodular and focally pseudocystic. It was composed of small and large round cells arranged diffusely, in trabeculae and pseudoglandular structures (Fig
O'Brien R, Wieselthier JS, Lee JJ, Rogers GS, Koh HK. A Rapidly Growing Facial Nodule in an Elderly Man. Arch Dermatol. 1991;127(4):571–576. doi:10.1001/archderm.1991.04510010139019
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