Sinonasal mucosal melanomas in Quito, Ecuador

Abstract

Background: Head and neck mucosal melanoma account for 2 to 8% of head and neck melanomas, the majority of which arises in the nasal cavity or paranasal sinuses. The aim of this report was to review our experience on sinonasal malignant melanomas (SNMM) treated over a long period of time at a tertiary referral hospital.Methods: Clinical records of all of the patients operated on for SNMM at the Social Security Hospital and private clinics in Quito, Ecuador, were reviewed. Nineteen patients had histologically proven diagnosis. Eleven patients were men and mean age was 64. The most common presenting symptoms were nasal obstruction and epistaxis. Most tumors were located at the nasal fossa. Extranasal extension was present in 11 patients. Twelve had stage III- IV tumors. All patients were treated by surgery. Postoperative radiotherapy was given to 7.Results: Local recurrence (11 events) occurred in 9 cases. These 11 events were treated with surgery in 8, eventually associated to radiation therapy (RT) and chemotherapy (CT). Eight out of these 9 patients died. Five overall survival was 46%. Death was related to local disease and distant metastases. All stage I tumor patients are alive.Conclusions: Most sinunasal melanomas have a poor prognosis, mainly attributed to initial advanced local disease, local recurrence and distant metastasis. Surgery is the mainstay treatment, followed by radiotherapy, according to the T category.