Introduction:

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin cancer that usually appears as a flesh-colored or bluish-red nodule on the face, head, or neck. MCC is primarily found in older adults.

Case presentation:

An 85-year-old white man visited the breast care service of the Servicio de Mastología del Instituto Nacional de Oncología y Radiobiología (National Institute of Oncology and Radiobiology, or INOR by its acronym in Spanish) in Havana, Cuba, due to an increase in volume, color change, and a burning sensation in the right breast. The patient had suffered thermal trauma to the right hemithorax 18 years before the consultation, which was treated with a skin graft of the thigh. Imaging studies (ultrasound, mammography, magnetic resonance imaging, and computed tomography) showed a nodule with imaging features suggestive of malignancy. CCM diagnosis was confirmed by core needle biopsy, reporting positivity of CD-56, CK-7, and Ki-67 markers.

Conclusions.

Typically, MCC presents as a rapidly growing, firm skin nodule in sun-exposed areas, contrary to the present case, in which the lesion appeared on grafted skin on the right hemithorax. Recognizing imaging findings suggestive of this neoplasm is of great importance for its diagnosis in unusual areas of the body, such as the breast.

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