Mélanomes des muqueuses nasosinusiennes

The melanoma, having its origin in the melanocyte cells, is one of the most aggressive forms of skin cancer in the world with one of the highest rates of brain metastasis. The incidence of cutaneous melanoma in the Mediterranean countries varies from three to five cases/ 100 000 people/year. Its prognosis is based on an early diagnosis. Sinonasal mucosal melanoma (SNMM) is an extremely rare tumor, accounting for 0.3-2% of all melanomas. The non-specific symptomatology is often delaying the presentation of the patient at the hospital and therefore the diagnosis. The SNMM is a highly aggressive tumor, and the presence of metastasis at the diagnosis usually implies a poor prognosis. The management of the melanomas requires a precise pre-therapeutic assessment and a multidisciplinary approach for the diagnosis, with surgical treatment or radiotherapy required in order to ensure a better a quality of life. In this paper, we retrospectively analyzed two cases of mucosal melanoma and one case of cutaneous melanoma of the nose.

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“…The pathophysiology of amelanosis is still unknown [ 45 ]. The pathological study makes it possible to establish the diagnosis.…”

Section: ⧉ Discussionmentioning

confidence: 99%

Fortuitous discovery of melanomas in the ENT Department – a histopathological and immunohistochemical study

Trandafir

Tischer

Horhat³

et al. 2021

Rom J Morphol Embryol

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“…The common symptoms are nasal obstruction and epistaxis [5]. Tumors of the nasal cavity predominantly involve the septum and lateral wall, while tumors of the paranasal sinuses predominantly involve the maxillary sinus followed by the ethmoid, frontal and sphenoidal sinuses [6]. The diagnosis is histological.…”

Section: Discussionmentioning

confidence: 99%

Management of Sinonasal Melanoma: Case Report

Erraisse¹

2018

IJNMRS

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A patient aged of 70 years old presented a 6 months history of a right nasal bleeding and blockage. He was diagnosed with mucosal malignant melanoma. Loco regional extension in the CT and MRI showed involvement of the frontal sinus, sphenoidal sinus and suspected involvement of the medial wall of the orbit. He had surgical excision with removal of the tumor. Given the positive margins, adjuvant radiotherapy was indicated. The radiotherapy was delivered with intensity modulated radiation therapy (IMRT) technique in order to overcome anatomical complexity of the region, cover the tumor bed and preserve the organs at risk. Despite advances in techniques, there is still no impact on the overall survival.

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“…In some cases, multiple lesions (for instance, satellite lesions) can be frequently observed, even centimetres away from the main tumor, with spreading occurring along the mucosal/submucosal planes 16 . Macroscopically, the tumor was reddish-crimson, covered by greyish exudates and very friable, which consists in the fact that one third of mucosal melanomas are achromic 17 . Imagistic tests for sinonasal melanoma are of the utmost importance as they represent a key feature in tumor staging.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis is based on histological examination, which usually shows a malignant proliferation with a nesting growth pattern and marked cytological pleomorphism 17 . The presence of intracytoplasmic melanin pigment can be detected by the affinity for Fontana stain, but, if it is present, it is usually visible on hematoxylin-eosin.…”

Section: Discussionmentioning

confidence: 99%

Primary sinonasal mucosal melanoma – Case report and literature review

Evsei

Birceanu-Corobea

Melinte

et al. 2017

Romanian Journal of Rhinology

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BACKGROUND. Primary sinonasal mucosal melanoma is a rare tumor with a poor survival rate. There is an inherent difficulty in diagnosing these lesions, especially because their complex anatomic locations and symptoms can be frequently confused with other benign or malignant processes. The purpose of our study was to report a difficult case and review the literature and recent research on therapeutic modalities. MATERIAL AND METHODS. We herein report a 61-year-old female patient, with a history of right eye enucleation and prosthesis, who presented with obstruction of the left nostril, anterior and posterior mucopurulent rhinorrhea, anosmia, left facial numbness, left exophthalmia accompanied by ipsilateral epiphora and decreased visual acuity. RESULTS. Clinical and imagistic testing revealed a large, grayish, fleshy tumor localized in the left maxillary sinus, with extension to the left orbit (producing osteolysis of the inferior and medial orbital walls), nasopharynx, ethmoidal cells and left frontal sinus. Pathological and immunohistochemical examination confirmed the diagnosis of mucosal melanoma. Other primary sites were excluded. The patient succumbed shortly after, following only palliative treatment. CONCLUSION. Early diagnosis of primary sinonasal mucosal melanoma is essential but very difficult to detect. Any symptoms such as unilateral epistaxis or nasal obstruction in a patient over the age of 60 should be rendered suspicious. Pathological and immunohistochemical examination for diagnosis and prognostic factors are important. Although surgery is the first option for treatment, one must consider, according to tumor staging, radiotherapy and chemotherapy with immunotherapy as a viable course of treatment for advanced cases.

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Mélanomes des muqueuses nasosinusiennes

Cited by 8 publications

References 10 publications

Fortuitous discovery of melanomas in the ENT Department – a histopathological and immunohistochemical study

Fortuitous discovery of melanomas in the ENT Department – a histopathological and immunohistochemical study

Management of Sinonasal Melanoma: Case Report

Primary sinonasal mucosal melanoma – Case report and literature review

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