Mucosal melanoma of the sinonasal tract

Mucosal melanoma of the sinonasal tract is an uncommon clinical entity, which frequently presents in advanced stages and follows an unpredictable course. We describe a case of a 97-year-old white female who presented with a 5-month history of painless, intermittent epistaxis and who was found to have melanoma involving the right inferior turbinate. She required operative intervention because of chronic epistaxis that had resulted in anemia and weakness. The case is presented along with a review of the pertinent literature. The dilemmas involved in the clinical decision-making process and treatment of malignancy in the elderly patient are discussed. In general, treatment outcomes in cases of mucosal melanoma are poor despite combination therapy, and quality-of-life issues become as important as attempts at complete extirpation.