Malignant Amelanotic Melanoma of the Middle Ear

Abstract

We report the first case (to our knowledge) of malignant melanoma of amelanotic type arising from the mucosa of the middle ear. An 81-year-old man who presented with right hearing loss was diagnosed as having otitis media with effusion at an otolarygology clinic. Despite subsequent treatment, he developed otorrhea and otalgia. Furthermore, a granular mass was found in the pars flaccida of the tympanic membrane. A biopsy of the mass was performed, and the findings were suggestive of malignant melanoma. The disease was already in an advanced stage, because metastases were noted in the patient's lungs and liver. Although chemohormonal therapy was performed and was slightly effective in reducing the primary tumor, the patient died of acute renal failure. Autopsy confirmed the diagnosis of amelanotic melanoma of the middle ear.

Imaging Finding of Malignant Melanoma of Eustachian Tube with Extension to Middle Ear Cavity: Case Report

“…CT is useful to determine the bone change, but it is difficult to make a differential diagnosis by CT alone because bone destruction is negligible and the ossicles are intact in malignant melanoma of the middle ear cavity (8). Moreover, the inferior soft-tissue resolution of CT make the diagnosis more difficult (5).…”

“…Characteristic MR imaging findings of high signal intensity on T1-weighted image and low signal intensity on T2-weighted image are due to higher content of melanin in the tumor (10). Conversely, in cases of an amelanotic melanoma, the signal intensity of the mass can demonstrate low signal intensity on T1-weighted images and high signal intensity on T2-weighted images (8, 11). …”

Malignant Melanoma of the Temporal Bone Initially Presenting with Dizziness

“…However, primary malignant melanoma of the middle ear mucosa is extremely rare; only six reports have been published. [6][7][8][9][10][11] Most studies have shown that radical resection of the pri-mary tumor with negative margins may provide the best therapeutic results for head and neck mucosal melanoma. However, negative margins can be very difficult to obtain due to microscopic spread that cannot be identified grossly.…”

Melanoma of the middle ear: initial presentation, Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography imaging and follow up

“…[3][4][5][6] Approximately 1.3 per cent of all melanomas arise within the mucosal surfaces of the body, and 55 per cent of these occur in the head and neck. 7 The treatment of mucosal melanomas is challenging.…”