Catastrophic Merkel Cell Carcinoma in a Liver Transplant Recipient

Merkel cell carcinoma (MCC) is a rare skin cancer, difficult to diagnose, and carries high mortality rate. Solid organ transplant recipients (SOTR) are at disproportionately increased risk of MCC other malignancies due chronic immunosuppression. We discuss the case 47-year-old woman with remote history liver on immunosuppression tacrolimus for over decade who presented third recurrence her left forearm. This report underscores importance risk-stratified approach regular dermatologic care cancer screening in this vulnerable population.