Merkel cell carcinoma of the eyebrow extending into the orbit

BACKGROUND: Merkel cell carcinoma is a rare and aggressive cutaneous neoplasm with high local recurrence and metastatic rates. PURPOSE: To highlight an unusual presentation of a Merkel cell carcinoma. CASE REPORT: We report a large Merkel cell tumor in an 85-year-old woman. It extended from the eyebrow into the upper nasal orbit posterior to the equator of the eye globe. Local resection resulted in microscopically complete removal of the tumor. During follow-up (20 months) no local recurrence was noticed but there was a metastasis in a lymphatic nodule. CONCLUSIONS: Merkel cell carcinoma often presents in the eyelids and periorbital region. However, extension from the eyebrow deep into the orbit is unusual.