Recurrence in a patient with a 10-year history of sinonasal mucosal melanoma manifesting as facial swelling

Abstract

Sinonasal mucosal melanoma is a rare tumor that develops slowly and may manifest with non specific signs and symptoms, causing significant delay in diagnosis. Local recurrence is common and usually occurs within the first two years after the initial treatment. Prognosis of recurrent lesions is poor and 5-year survival ranges between 10-47%. We report the clinical, radiographic, histopathological and immunohistochemical findings of a recurrent sinonasal mucosal melanoma which was diagnosed 10 years after the initial treatment, in a patient who presented with unilateral facial swelling and one-sided difficulty in breathing of two years duration. We discuss the causes of late diagnosis and review the negative predictive factors for recurrence and survival. As early diagnosis is of paramount importance for prognosis, we emphasize the signs and symptoms of patients with a history of sinonasal mucosal melanoma which should raise the suspicion for recurrence, in spite of a long time interval since diagnosis. Key words: Mucosal melanoma, nasal cavity, sinus, recurrence.

Carbon ion radiotherapy with complete tumor regression for primary malignant melanoma of female urethra orifice: a case report

“…15 , 16 About 50% of mucosal melanomas occur in the head and neck region (nasal cavity, sinuses, and oropharynx), about 30% occur in the gastrointestinal tract (esophagus, rectum, and anal canal), and approximately 20% involve the genitourinary tract (vagina, cervix, bladder, and urethra); mucosal melanomas occasionally originate from other mucosal areas. 17 Clinical manifestations of PMMFU include a mass of the urethra, hematuria, and urinary tract obstruction. Our patient presented with a mass in the external urethral orifice with a typical dark brown appearance.…”

“…There is no standard treatment protocol for urothelial MM, but most experts recommend radical resection. 17 However, because of the complex anatomy and delicate physiological function of the urogenital tract in which the tumor is located, achieving R0 resection with surgical treatment is often challenging and is likely to result in the loss of physiological function. Furthermore, the recurrence rate of urothelial MM is as high as 71% regardless of the surgical approach.…”

“…Furthermore, the recurrence rate of urothelial MM is as high as 71% regardless of the surgical approach. 17 Davuluri et al. 6 described a patient with a 49-mm PMMFU who developed recurrence and metastasis 5 months after surgical treatment.…”

“…Furthermore, the recurrence rate of urothelial MM is as high as 71% regardless of the surgical approach. 17 Davuluri et al 6 described a patient with a 49-mm PMMFU who developed recurrence and metastasis 5 months after surgical treatment. The patient underwent salvage pelvic radiotherapy and immunotherapy and eventually died of metastatic disease 11 months after surgery.…”