{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T05:19:01Z","timestamp":1787548741507,"version":"build-2736575974"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Merkel cell carcinoma (MCC) of the eyelid is a rare, aggressive cutaneous neuroendocrine malignancy. We report three patients with upper eyelid MCC managed at a single ophthalmology centre. Patients were aged 74, 78 and 65 years; two were female and one male. All underwent wide local excision and complex eyelid reconstruction using Cutler-Beard and adjunctive flap techniques. Outcomes differed substantially: the patient who underwent neither nodal staging nor adjuvant therapy developed parotid metastases within two months and died at 4.5 months. The two patients in whom nodal staging was performed remain disease-free at 35 and 13 months, respectively, despite also not receiving adjuvant radiotherapy. These cases illustrate the diagnostic challenge of periocular MCC and are consistent with guideline recommendations for nodal staging, although a series of three patients cannot separate the effect of staging from that of performance status.<\/jats:p>","DOI":"10.3389\/fonc.2026.1935668","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T04:23:25Z","timestamp":1787545405000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: The role of nodal staging in periocular merkel cell carcinoma \u2014 lessons from three cases"],"prefix":"10.3389","volume":"16","author":[{"given":"Wojciech","family":"Adamski","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Regional Hospital in Poznan, The Greater Poland Specialist Center","place":["Poznan, Poland"]},{"name":"Laboratory of Vision Science and Optometry, Faculty of Physics and Astronomy, Adam Mickiewicz University","place":["Poznan, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Rzeszotarska","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Regional Hospital in Poznan, The Greater Poland Specialist Center","place":["Poznan, Poland"]},{"name":"Laboratory of Vision Science and Optometry, Faculty of Physics and Astronomy, Adam Mickiewicz University","place":["Poznan, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Paprzycka","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Regional Hospital in Poznan, The Greater Poland Specialist Center","place":["Poznan, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2019.03.002","article-title":"Merkel cell carcinoma of the eyelid: a review","volume":"64","author":"North","year":"2019","journal-title":"Surv Ophthalmol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1001\/jamaophthalmol.2013.6077","article-title":"Merkel cell carcinoma of the eyelid: management and prognosis","volume":"132","author":"Herbert","year":"2014","journal-title":"JAMA Ophthalmol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"17077","DOI":"10.1038\/nrdp.2017.77","article-title":"Merkel cell carcinoma","volume":"3","author":"Becker","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.11.020","article-title":"Clinical characteristics of Merkel cell carcinoma at diagnosis in 195 patients: the AEIOU features","volume":"58","author":"Heath","year":"2008","journal-title":"J Am Acad Dermatol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2024.01.010","article-title":"Merkel cell carcinoma and the eye","volume":"42","author":"Valentini","year":"2024","journal-title":"Clin Dermatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2020.07.031","article-title":"Sentinel lymph node biopsy for eyelid and conjunctival Malignancy: a report by the American Academy of Ophthalmology","volume":"127","author":"Freitag","year":"2020","journal-title":"Ophthalmology"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(99)90161-6","article-title":"Epidemiologic characteristics and clinical course of patients with Malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota","volume":"106","author":"Cook","year":"1999","journal-title":"Ophthalmology"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30673-4","article-title":"Sebaceous carcinoma: evidence-based clinical practice guidelines","volume":"20","author":"Owen","year":"2019","journal-title":"Lancet Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/medicina61040612","article-title":"Aggressive squamoid eccrine ductal carcinoma of the face: a rare and challenging diagnosis. 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