[Young patient with eyelid Merkel carcinoma: Mohs microsurgery versus exenteration]. / Paciente joven con carcinoma de Merkel palpebral: microcirugía de Mohs versus exenteración.

CASE REPORT: We present the case of a 47-year-old female suffering from progeria who developed an eyelid Merkel cell carcinoma (MCC) following cyclosporine treatment for a corneal transplant. She underwent excision of the lesion by Mohs micrographic surgery (MMS) and received adjuvant treatment with radiotherapy. Later she had a recurrent tumour for which a wide excision with orbital exenteration was performed. The patient was fit and well at the 24-month follow-up. DISCUSSION: MCC is an aggressive tumour that has a larger incidence in elderly people, women and immunosuppressed patients. Our approach with the patient must be global, avoiding risk factors in predisposed subjects. MMS seems unsuitable for the treatment of MCC; if tumour recurrence occurs a wide resection should be performed (Arch Soc Esp Oftalmol 2009; 84: 581-584).

Paciente joven con carcinoma de Merkel palpebral: microcirugía de Mohs versus exenteración / Young patient with eyelid Merkel carcinoma: Mohs microsurgery versus exenteration

Caso clínico: Se presenta el caso de una pacientede 47 años afecta de progeria que después de tratamientocon ciclosporina por trasplante corneal presentócarcinoma de Merkel (MCC) palpebral. Trasexéresis completa mediante cirugía de Mohs(MMS) y tratamiento adyuvante con radioterapia,recidivó y fue necesario realizar exenteración orbitaria.La paciente se encuentra asintomática tras 24meses de seguimiento.Discusión: El MCC es un tumor agresivo conmayor incidencia en ancianos, mujeres e inmunodeprimidos.Nuestra visión del enfermo debe ser globalevitando añadir factores de riesgo a pacientes yapredispuestos. La MMS parece desaconsejada en eltratamiento del MCC, debiendo realizar una excisiónradical si se produce recidiva(AU)

Case report: We present the case of a 47-year-oldfemale suffering from progeria who developed aneyelid Merkel cell carcinoma (MCC) followingcyclosporine treatment for a corneal transplant. Sheunderwent excision of the lesion by Mohs micrographicsurgery (MMS) and received adjuvant treatmentwith radiotherapy. Later she had a recurrenttumour for which a wide excision with orbital exenterationwas performed. The patient was fit and wellat the 24-month follow-up.Discussion: MCC is an aggressive tumour that hasa larger incidence in elderly people, women andimmunosuppressed patients. Our approach with thepatient must be global, avoiding risk factors in predisposedsubjects. MMS seems unsuitable for thetreatment of MCC; if tumour recurrence occurs awide resection should be performed(AU)