Cornea & external disease · practice question
[READINESS SEED] An elderly patient has a rapidly growing, painless, violaceous…
[READINESS SEED] An elderly patient has a rapidly growing, painless, violaceous (red-purple) firm nodule on the upper eyelid that appeared over weeks. Which malignancy does this most likely represent?
Show the answer and explanationAnswer and explanation
Answer: A. Merkel cell carcinoma
A rapidly enlarging, violaceous, firm eyelid nodule in an elderly patient suggests Merkel cell carcinoma, an aggressive neuroendocrine tumor with a high rate of nodal and distant metastasis. Its speed and color separate it from the pearly, slow basal cell carcinoma.
Clinical pearl: Merkel cell carcinoma metastasizes early, so sentinel-node assessment and prompt oncologic referral are part of management.