Surgical Management of Primary Nasal Mucosal Melanoma: A Case Report

Primary sinonasal mucosal melanoma (PSMM) is a rare and aggressive malignancy of the nasal cavity and paranasal sinuses. PSMM presents significant diagnostic and therapeutic challenges due to its nonspecific symptoms, complex anatomy, and high recurrence rate. Due to its vague symptoms, diagnosis is often delayed, leading to poor outcomes. Early detection and prompt surgical intervention are crucial for improving prognosis. Surgical excision with clear margins remains the primary treatment, while the role of adjuvant therapies continues to develop. We present the case of a 56-year-old male patient with progressive left-sided nasal obstruction, intermittent epistaxis, and anosmia. Nasal endoscopy revealed a pigmented mass in the left nasal cavity. Histopathological examination and immunohistochemistry confirmed the diagnosis of mucosal melanoma. The patient underwent endoscopic surgical resection followed by adjuvant radiotherapy, with no postoperative complications. He remains under close follow-up. This report aims to highlight the surgical approach to a rare case of PSMM. This case highlights the importance of early detection and intervention and underscores the need for continued case reporting to inform future management approaches.