A 78 year old Caucasian woman, was admitted to the hospital for evaluation of a mass to the anterior surface of the left mandibular angle and left submandibular area present for the past year with rapid acceleration of growth over three weeks prior to admission. An incisional biopsy was performed and initial diagnosis of poorly differentiated neuroendocrine carcinoma (small cell carcinoma) was made. Dermatological evaluation revealed lesion was suspicious for Merkel cell carcinoma and the pathology specimen was re-analyzed and differential diagnoses was made for Merkel cell carcinoma. Patient was educated and discharged to a nursing home with plan for irradiation, chemotherapy, and outpatient follow up. This case study serves to raise awareness of a rare condition and describe how Merkel cell carcinoma may be mistaken for similarly presenting neuroendocrine tumors.
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