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Case Reports
. 2025 Jul;14(7):3008-3012.
doi: 10.4103/jfmpc.jfmpc_1586_24. Epub 2025 Jul 21.

Unmasking the uncommon: Merkel cell carcinoma mimicking benign upper lip swelling in an elderly patient

Zeinab Fathy Elsayed  1 , Rahul Unnikrishnan  1 , Ahmed Elsayed Foul  1
Affiliations
Case Reports

Unmasking the uncommon: Merkel cell carcinoma mimicking benign upper lip swelling in an elderly patient

Zeinab Fathy Elsayed et al. J Family Med Prim Care. 2025 Jul.

Abstract

Merkel cell carcinoma (MCC) is a rare neuroendocrine carcinoma with aggressive behavior that predominantly affects the sun-damaged skin of the head and neck regions, extremities, and trunk of white older individuals. We present a unique case of MCC presenting as painless upper lip swelling, initially mistaken for a benign lesion. Histopathological examination revealed characteristic features of MCC. Early diagnosis and intervention led to improved outcomes. This case emphasizes the importance of considering MCC in the differential diagnosis of seemingly innocuous cutaneous lesions. To the best of our knowledge, 24 cases of MCC of the lips have been reported to date in the English language literature, and this case is probably the first to be reported from the Middle East region.

Keywords: Elderly; Merkel cell carcinoma; lip.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Neoplasm is composed of cells arranged in sheets, nests and trabeculae
Figure 2
Figure 2
Cells are positive for synaptophysin
Figure 3
Figure 3
Section shows skin with dermis showing an infiltrating neoplasm
Figure 4
Figure 4
Cells are small, round with high nuclear cytoplasmic ratio, round vesicular nuclei with small nucleoli. Cytoplasm is scanty. Stroma showing lymphocytic infiltration
Figure 5
Figure 5
Cells are positive for CKAE1/AE3
Figure 6
Figure 6
Cells are negative for TTF-1
See this image and copyright information in PMC

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