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Management and outcomes of periorbital Merkel cell carcinoma: a tertiary eye centre experience

Eye volume 39, pages 1011–1014 (2025)Cite this article

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Periocular Merkel cell carcinoma (MCC) accounts for 2.5 to 10% of all reported cases. With five-year survival rates between 40 and 63% [1, 2], it is an aggressive skin tumour most often associated with ultraviolet exposure, the Merkel cell polyomavirus (MCPyV) and immunosuppression. In 2021, NICE approved the use of avelumab as first line treatment in metastatic MCC based on data from the JAVELIN Merkel 200 trial which showed better survival and response duration when indirectly compared to chemotherapy in treatment naive cases [3]. In this article, we describe our experience with nine periorbital MCC cases between 2013 and 2023 and the use of immune checkpoint inhibitors (ICI) in non-surgical candidates and in advanced metastatic tumours.

Table 1 summarises the patient demographics, tumour presentation, investigations, management, and outcomes of our case series.

Table 1 Summary of tumour presentations, management, and outcomes in nine periorbital MCC cases between 2013 and 2023.
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Fig. 1: Large periorbital Merkel lesions in two patients treated with avelumab.

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Raw data are available from the corresponding author upon reasonable request.

References

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Authors and Affiliations

  1. Moorfields Eye Hospital NHS Foundation Trust, London, UK

    Li Teng Kok, Allan Z. Nghiem, Jimmy M. Uddin, Tarang Gupta & Clare S. Daniel

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  1. Li Teng Kok
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  2. Allan Z. Nghiem
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  3. Jimmy M. Uddin
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  4. Tarang Gupta
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  5. Clare S. Daniel
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Contributions

Data collection: LTK Data analysis and interpretation LTK, AN, CD. Supervision: CD, TG, JU Writing – original draft: LTK Writing- review and editing: AN, TG, JU, CD.

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Correspondence to Li Teng Kok.

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The authors declare no competing interests.

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Kok, L.T., Nghiem, A.Z., Uddin, J.M. et al. Management and outcomes of periorbital Merkel cell carcinoma: a tertiary eye centre experience. Eye 39, 1011–1014 (2025). https://doi.org/10.1038/s41433-025-03649-w

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