Document Type

Article

Publication Title

Cureus

Abstract

Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine tumor, known for its rapid progression and poor prognosis. It most commonly affects elderly and immunocompromised individuals, with variable clinical presentations that can make diagnosis challenging. MCC is often mistaken for other skin malignancies, such as basal or squamous cell carcinoma, or even benign skin lesions. Early diagnosis is critical to initiate appropriate treatment, typically involving surgery, radiation, and immunotherapy. This report describes a 66-year-old man diagnosed with MCC with regional lymph node involvement. Immunotherapy was started promptly; however, within a year, the disease progressed to the mediastinum, involving the esophagus and trachea, an uncommon site of metastasis. The patient ultimately died in the ICU from respiratory failure. This case highlights the aggressive behavior of MCC and underscores the importance of vigilant follow-up, even after early diagnosis. Once metastasis to the lymph nodes occurs, MCC becomes particularly challenging to manage, especially when it follows an atypical metastatic pattern.

DOI

10.7759/cureus.88816

Publication Date

7-26-2025

Keywords

acute decompensated respiratory failure, cancer metastasis, distal metastasis, merkel cell carcinoma (mcc), oncology department, tumor mass effect

ISSN

2168-8184

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