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- Title
Sinonasal mucosal melanoma - a case report.
- Authors
Kusiński, Maciej; Adamek-Nowak, Dorota; Lepka, Paulina; Łuczak, Klaudiusz
- Abstract
Sinonasal mucosal melanoma is a rare tumor with very poor prognosis. It develops from melanocytes arisen from multipotent neural crest cells which travel along peripheral nerves to the skin, eye and mucosal membranes during embryogenesis. Mucosal melanoma of the nasal cavity is characterized by nonspecific symptoms and is often diagnosed in an advanced stage. The neoplasm occurs mainly in the 6th and 7th decade of life. For effective management, complete surgical resection is required; neck dissection is not usually performed. The management involves primary surgery whereas the efficacy of neck dissection is not proven and constitutes a source of controversy). Chemotherapy, biological therapy and radiotherapy are used as additional treatment. Radiotherapy brings good local control but, following recent reports, its survival benefit is questionable. The clinical picture of nasal mucosal melanoma is more aggressive than skin melanoma. Median overall survival is 32 months. Immunohistochemistry is the basic study in the histopathological diagnosis. A 53-year-old female was admitted to the Department of Otolaryngology because of severe epistaxis. Upon admission, endoscopy revealed a polyp like tumor in the right middle nasal meatus. The histopathological examination of a biopsy specimen stated: malignant amelanotic melanoma S-100/+/, Melan A/+/, HMB 45 /+/ pan CK /-/. A tumor occupying the right middle nasal meatus and the right ethmoid sinus, infiltrating the right eye socket with bone destruction was described in computed tomography. The patient underwent radical surgical treatment. PET-CT control showed features of local recurrence and metastatic disease eight weeks after surgery despite negative margins of excision. Palliative chemoradiotherapy was conducted.
- Subjects
RADIOTHERAPY complications; MUCOUS membrane cancer; TUMOR prevention; TUMOR surgery; MEDICAL radiology
- Publication
Onkologia i Radioterapia, 2017, Vol 40, Issue 2, p16
- ISSN
1896-8961
- Publication type
Article