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Merkel cell carcinoma (MCC) is a rare skin neoplasm. Tang and Toker1 first described MCC in 1978 and since then 19 cases in association with chronic lymphocytic leukaemia (CLL) have been reported. 2–5 To the best of our knowledge, involvement of the eyelid by MCC has never been reported in the literature in association with CLL.

Case report An 84 year old white man was referred with an 8 week history of a painless lump on his right upper eyelid (Fig 1A). He was complaining of visual obscuration secondary to a mechanical ptosis. Ophthalmic history was unremarkable and specifically there were no previous chalazions or trauma. On examination a firm lesion of the right eyelid measuring 2× 1 cm with overlying telangiectatic vessels and sparing of the eyelashes was noted (Fig 1A). Further ophthalmic examination was unremarkable. General examination did not reveal any abnormalities. General medical …