Management and prognosis of Merkel cell carcinoma of the eyelid

Objective To evaluate the clinical presentation, treatment, and long-term follow-up of eyelid Merkel cell carcinoma. Design Retrospective noncomparative interventional case series. Participants Fourteen patients with primary eyelid Merkel cell carcinoma. Methods Cases of Merkel cell carcinoma for which long-term follow-up was available were solicited from members of the American Society of Ophthalmic Plastic and Reconstructive Surgery through an on-line e-mail/news group. Main outcome measures Follow-up period, treatment history, presence and type of recurrence, and mortality. Results Average follow-up was 33.4 months. Of the 14 cases identified, only 2 patients (14%) received prophylactic therapy beyond wide surgical excision. Three patients (21%) had recurrences, none of whom initially received prophylactic therapy (i.e., radiation therapy, lymph node dissection, and/or chemotherapy) beyond wide surgical excision. One patient (7%) died of metastatic Merkel cell carcinoma. Conclusions Merkel cell carcinoma is a rare skin malignancy that occasionally affects the eyelid, with the potential for regional and distant metastasis. Consideration should be given to the use of prophylactic adjunctive therapies beyond wide surgical excision while simultaneously considering the morbidity of these therapies.