Not every nasal block is allergic rhinitis: a case report of sinonasal malignant melanoma

Sinonasal malignant melanoma (SNMM) is an extremely rare and aggressive sinonasal tumor. It has nonspecific risk factors and clinical presentation which require a high index of suspicion. In this case report we present a case of a 47-year-old male who initially had persistent nasal obstruction not responding to intranasal steroids. Comprehensive imaging and histopathological studies confirmed SNMM. He underwent incomplete maxillectomy resection followed by immunotherapy abroad. Within 6 months period he had recurrence of the disease. As this disease is a rare entity, there are no specific treatment guidelines, however, surgical intervention is agreed to be the mainstay of treatment. Although their effectiveness is still controversial, radiation therapy, chemotherapy, immunological and biological therapies are adjuvant options. Multidisciplinary team approach is necessary to provide the optimal treatment plan, along with close follow up. Continuous research and clinical trials are still needed to ensure appropriate diagnosis and management of this rare entity.