Mucosal melanoma of the nasal cavity and paranasal sinuses

Gilain, L.; Houette, A.; Montalban, A.; Mom, T.; Saroul, N.

doi:10.1016/j.anorl.2013.11.004

Cited by 87 publications

(124 citation statements)

References 35 publications

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“…Other symptoms are represented by diplopia and proptosis 4 . Nasal obstruction is usually unilateral, permanent and progressive, frequently associated with other symptoms, while epistaxis can be abundant or minimal 12 . In most cases, patients do not have early symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Recent series suggest that, specifically for mucosal melanoma of nasal cavity and paranasal sinuses, the mean survival does not exceed 40% in 28 months 12 . Depending on location, disease-specific survival at 5 years was 36.66% for those patients with nasal cavity disease, 23.80% for patients with maxillary sinus disease and 18.20% for patients with ethmoid sinus disease 43 .…”

Section: Discussionmentioning

confidence: 99%

“…This fact is explained mostly by the multifocal nature of these lesions and lymphatic and vascular invasion. The most common metastatic sites are lungs, liver, bone and rarely brain and adrenal glands 12 . Metastases are found in about 50% of cases, sometimes during the course of the disease, while lymph nodes are found in 20-40% of cases 45 .…”

Section: Discussionmentioning

confidence: 99%

“…The first case of mucosal melanoma in English literature was published by Lincoln et al in 1885 11 . The mean age at diagnosis is between 65 and 70 years 12 . Our case, on the other hand, is younger.…”

Section: Discussionmentioning

confidence: 99%

“…Several parameters are evaluated on histological examination: morphology and cellular architecture, pigmentation, presence of ulceration, percentage of necrosis, number of mitoses, inflammation, perineural, lymphatic and vascular invasion. Confirmation of the diagnosis is based on immunohistochemistry using a panel of markers 12 . S100 is an acidic protein, 100% soluble in ammonium sulphate at neutral pH, a common marker used in pathology.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary sinonasal mucosal melanoma – Case report and literature review

Evsei

Birceanu-Corobea

Melinte

et al. 2017

Romanian Journal of Rhinology

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Unilateral Nasal Congestion in an Elderly Man

Cai

Parasher

Palmer

2017

JAMA Otolaryngol Head Neck Surg

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A man in his 70s presented to an outside institution with a 4-month history of right-sided nasal congestion, which failed to resolve with nasal sprays, antibiotics, and oral prednisone. He also reported intermittent right-sided epistaxis occurring multiple times per day. He had not experienced prior nasal trauma or surgery and had quit smoking 30 years ago. At the outside institution, a nasal mass was found on examination and biopsied. He was referred to our office for further management. Endoscopic examination showed a dark, soft-tissue mass filling the right nasal cavity. Computed tomography (CT) of the sinuses revealed opacification of the right nasal cavity with tissue protruding into the nasopharynx and complete opacification of the right maxillary, anterior ethmoid, and frontal sinuses (Figure , A and B). The patient underwent surgical resection. Removal of the mass required a right medial maxillectomy, septectomy, and excision of the right nasolacrimal duct via endoscopic approach. Resection also necessitated removal of the anterior maxillary sinus wall via Caldwell-Luc procedure. Biopsy specimens were taken throughout. Histopathologic analysis from both the outside hospital and our institution revealed sheets of atypical, pleomorphic epithelioid cells, some with prominent pigment (Figure, C). Immunohistochemical stains were positive for HMB-45 (Figure, D) and S-100.

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