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Malignant Melanoma of Nose and Paranasal Sinuses: a Case Series
Safeer Mohammed1, Vijendra Shenoy1, Kamath Mulky Panduranga1
1Department of Otorhinolaryngology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India.
Abstract:
Malignant melanoma of nose and paranasal sinus is a rare and devastating disease. The incidence of intranasal malignant melanomas varies from 0.6 to 3.8%. Extensive local invasion, tumor recurrence, distant metastasis accounts for the poor prognosis with advanced stage having mean survival time of 3.5 years. Here we report 2 cases of malignant melanoma of the left nasal cavity with extensive local invasion to paranasal sinuses and destroying medial orbital wall in both cases along with one eroding cribriform plate and extending intracranially. Both the patient presented with almost similar complaints of unilateral nasal obstruction progressing to bilateral with intermittent episodes of epistaxis and unilateral epiphora. Biopsy from the lesion was proved out to be Malignant melanoma in both the cases. All preliminary radiological investigations including metastatic workup was done. Though there was no evidence of distant metastasis in both the cases, because of extensive local destruction and patient's preference, both opted for non-surgical management.
Insights
This study reports two rare cases of malignant melanoma in the nasal cavity and paranasal sinuses. Both patients presented with extensive local invasion and opted for non-surgical management due to disease severity.
Area of Science:
- Oncology
- Otorhinolaryngology
- Pathology
Background:
- Malignant melanoma of the nose and paranasal sinuses is a rare and aggressive malignancy.
- Intranasal malignant melanomas account for 0.6–3.8% of all melanomas.
- Poor prognosis is associated with extensive local invasion, recurrence, and distant metastasis.
Purpose of the Study:
- To report two cases of malignant melanoma of the nasal cavity with extensive local invasion.
- To highlight the clinical presentation, diagnostic workup, and management of these rare tumors.
Main Methods:
- Case report of two patients diagnosed with malignant melanoma of the left nasal cavity.
- Clinical evaluation including symptoms of nasal obstruction, epistaxis, and epiphora.
- Diagnostic imaging (radiological investigations) and biopsy for histopathological confirmation.
- Metastatic workup to assess for distant disease.
Main Results:
- Both cases presented with extensive local invasion into paranasal sinuses, destruction of the medial orbital wall, and intracranial extension (one case).
- Common symptoms included progressive unilateral nasal obstruction, epistaxis, and unilateral epiphora.
- Biopsy confirmed malignant melanoma in both patients.
- No distant metastasis was detected in either case.
Conclusions:
- Malignant melanoma of the nasal cavity and paranasal sinuses requires prompt diagnosis and management.
- Despite the absence of distant metastasis, extensive local invasion may necessitate non-surgical treatment options.
- These cases underscore the devastating potential and challenging management of intranasal malignant melanoma.
