We describe a 71-year-old male patient admitted to the hospital with posterior chest pain. Following the detection of a paravetebral mass at the level of the 2(nd) thoracic vertebra, the patient underwent a surgical en bloc resection of the mass. The histopathologic examination revealed a Merkel cell carcinoma. One month after the operation, magnetic resonance imaging showed an inoperable mass in the same location, which indicated a rapid progression of the tumor. The patient died of progressive respiratory failure due to pneumonia on the 6(th) day after the onset of radiochemotherapy. Although this appears to be an isolated case, Merkel cell carcinoma must be included in the differential diagnosis of intrathoracic masses.