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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. 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 marke