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- Title
RADIOLOGICAL REVIEW OF THE SINONASAL MUCOSAL MELANOMA - CASE REPORT.
- Authors
Prenc, Matea; Špiljak, Bruno; Sviličić, Lara; Basuga, Mia Smoljan; Zadravec, Dijana
- Abstract
Aim: Sinonasal mucosal melanoma (SNMM) accounts for 2% of all melanomas and 55% of head and neck melanomas. Origin of the tumor is most often at the nasal septum, lateral walls of the nasal cavity and lower nasal concha. The tumor has a propensity for intraorbital and intracranial spread. The average age of onset is 65 years and the five-year survival rate is 30%. The aim of this paper is to emphasize pathognomonic features of tumor on magnetic resonance imaging (MRI) in order to distinguish SNMM from other pathological processes of the sinonasal region more reliably. Materials and Methods: A 60-year-old male patient reported swelling on the right side of the nose accompanied by nasal congestion, epistaxis and decreased visual acuity in the right eye for the past three months. MRI of the oromaxillofacial region was performed using a 1.5 T MRI machine in different sequences with additional application of contrast agent. Extensive tumor is seen in the nasal cavity spreading into paranasal cavities, epipharynx, both orbits and anterior cranial fossa. On T1WI the tumor is mostly hypointense with small areas of high signal intensity that may correspond to melanin. On T2WI the tumor has a heterogeneous appearance with hyperintense areas representing intratumoral necrosis. Parts of the tumor show restricted diffusion. Results: Contrast-enhanced T1WI shows heterogeneous imbibition of tumor tissue and imbibition of the dura and subarachnoid space frontobasally. Immunohistochemical analysis of the biopsied sample found tumor cells positive for melanoma-specific markers HMB-45 and Melan A. Conclusion: Paramagnetic properties of melanin responsible for high signal intensity on T1WI and low signal intensity on T2WI and diffusion restriction caused by a high-cellularity process along with clinical examination and immunohistochemical analysis with high reliability confirm the diagnosis of SNMM.
- Subjects
PARANASAL sinuses; NASAL cavity; NASAL septum; MAGNETIC resonance imaging; SUBARACHNOID space; MELANOMA; HEAD &; neck cancer
- Publication
Acta Stomatologica Croatica, 2023, Vol 57, Issue 2, p192
- ISSN
0001-7019
- Publication type
Article