Merkel Cell Carcinoma: Diagnostic and Therapeutic Challenges —A Case Report with Literature Review

Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine tumor predominantly affecting elderly and immunocompromised patients. It is characterized by a high propensity for local recurrence, regional lymph node involvement, and distant metastasis, leading to poor outcomes. Diagnosis remains challenging due to its rarity and nonspecific presentation, often leading to misdiagnosis. We report a case of locally advanced MCC originating in the gluteal region, exhibiting aggressive behavior. In the Moroccan context, where access to immunotherapy is limited, the patient was managed with chemotherapy, achieving transient disease control within a multimodal treatment strategy. This case report is accompanied by a literature review to discuss current therapeutic strategies and to underscore the challenges in managing MCC in resource-limited settings.