Complete remission of atypical Merkel cell carcinoma of eyelid with parotid gland and lymph node metastasis through chemotherapy

A 70-year-old woman presented with a painless and rapidly enlarging mass on her right lower eyelid that had developed within the previous 3 weeks. The patient underwent surgical excision of the tumor, and based on the histopathological findings, the tumor was characterized as a high-grade neuroendocrine carcinoma with positive resection margins. However, immunopathological staining was positive for neuroendocrine markers, but negative for epithelial markers, which is not typical of Merkel cell carcinoma (MCC). Chemotherapy (Etoposide and Cisplatin, five cycles) was administered, and complete remission was achieved without further surgical excision. No evidence of tumor recurrence was observed at the 2-year follow-up. The findings in this case suggest that chemotherapy may be a potential treatment option for patients with large, advanced MCC of the eyelid.