Background: Merkel cell carcinoma (MCC) is a rare primary cutaneous tumor. The standardized
imaging guidelines for the diagnosis of MCC have not been established. We report the
multimodality imaging features of MCC, including CT, MRI, and ultrasound with grayscale and
color Doppler mode as well as the elastography and even a histopathologic confirmation.
Case Report: We report the case of a 76-year old male patient with MCC on the elbow that was
treated by excision. On MRI, prominent T2 low signal voiding was noted with branching or chaotic
pattern and marked, branching, or chaotic vascularity was also seen on color doppler ultrasound.
Those findings corresponded to histology that showed increased vascularity in stromal tissues of
the tumor and in between the tumor cells.
Conclusion: A mass in the dermal and subcutaneous layer with marked and branching or chaotic
vascularity may be the unique characteristic that may contribute to early diagnosis of MCC.