Merkel cell carcinoma on the upper lip of a 100-year-old woman

Abstract

Merkel cell carcinoma (MCC) is a rare skin tumor that usually occurs on the head, neck, or extremities of elderly patients; it has a high incidence of local recurrence, regional lymph node metastasis, and subsequent distant metastasis. We report a MCC that developed rapidly on the left corner of the upper lip of a 100-year-old woman. An incisional skin biopsy was performed to confirm MCC. Computed tomography showed no metastasis. The tumor was widely excised with a margin of 1 cm. Immediate reconstruction with a reverse Estlander flap from the lower lip was performed under general anesthesia. Additional surgery was also performed under general anesthesia 2 weeks later to widen the patient's lips. The surgical results were satisfactory. The patient died of senile deterioration a year after hospitalization for long-term medical treatment, without any recurrence or metastasis of MCC. Despite the patient's age, we considered it necessary to resect the tumor widely because of its rapid growth. The tumor margin was 1 cm. No radiotherapy was performed, but we believe that surgery alone was effective in allowing this patient to live an additional year without recurrence or metastasis. To the best of our knowledge, this patient is the oldest person with MCC yet described.