title: A rapidly growing lid lump.
abstract: A 97-year-old woman presented with a 5-month history of a rapidly growing, painless, left upper eyelid lesion. Examination revealed a large vascularised, ulcerated nodule on the left upper lid, causing significant ptosis. Wide local excision of the lesion was performed and the wound was left to heal by secondary intention. Histology and immunohistochemistry of the lesion confirmed a diagnosis of Merkel cell carcinoma, a rare primary malignancy of the eyelid which has significant morbidity and mortality. Although uncommon, this diagnosis should always be considered in any patient with a rapidly growing lid lump. In view of the patient's age, known dementia and family wishes, the patient was managed conservatively, with no further investigations performed. She was due to be followed up in clinic on a regular basis, but has since died from other causes.
authors.affiliation: Ophthalmology Department, Queen Mary's Hospital, Kent, UK.
authors.forename: Su-Yin
authors.initials: SY
authors.lastname: Koay
authors.affiliation: Ophthalmology Department, Queen Mary's Hospital, Kent, UK.
authors.forename: Richard M H
authors.initials: RM
authors.lastname: Lee
authors.affiliation: Ophthalmology Department, Queen Mary's Hospital, Kent, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Hugkulstone
authors.affiliation: Ophthalmology Department, Queen Mary's Hospital, Kent, UK.
authors.forename: Ian Aureliano Stephen
authors.initials: IA
authors.lastname: Rodrigues
mesh_terms: D000369:Aged, 80 and over; D001706:Biopsy; D015266:Carcinoma, Merkel Cell / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005142:Eyelid Neoplasms / Q000175:diagnosis*; D005143:Eyelids; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010784:Photomicrography; D012878:Skin Neoplasms / Q000175:diagnosis*