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2017, Volume 33, Number 1, Page(s) 066-069
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DOI: 10.5146/tjpath.2013.01218 |
Mucosal Malignant Melanoma of Nasal Cavity Recurring a Year After Radiotherapy |
Cem ÇOMUNOĞLU1, Gamze MOCAN KUZEY1, Mete İNANÇLI2, Füsun BABA1, Hanife ÖZKAYALAR1 |
1Department of Pathology, Yakın Doğu University, Faculty of Medicine, LEFKOŞA, TURKİSH REPUBLIC of NORTHERN CYPRUS 2Department of Otolaryngology, Yakın Doğu University, Faculty of Medicine, LEFKOŞA, TURKİSH REPUBLIC of NORTHERN CYPRUS |
Keywords:
Nasal cavity, Malignant melanoma, Radiotherapy |
Objective: Sinonasal mucosal malignant melanoma is a rare entity. In
this report we present a nasal mucosal malignant melanoma case with
its histopathological and clinical features.
Case Report: An 88-year-old female patient presented with epistaxis
a month ago. Examination revealed a polypoid mass lesion of right
nasal cavity originating from the middle concha. Her medical
history revealed that she had been found to have a mass lesion in
the right nasal cavity 15 months ago. She then underwent a punch
biopsy from that lesion. A definitive histopathological diagnosis was
not made but it was declared that the lesion had been a malignant
epithelial tumor. The patient then had radiotherapy and the
lesion showed complete regression. One year after completion of
radiotherapy, the lesion recurred. Her last PET-CT showed multiple
metastatic foci. Endoscopic excisional biopsy was performed for
her recurrent lesion. Fragmented tumoral tissues were measured
as 3,6x3x0,5 cm. Macroscopically the tumor was brownish in color.
Histopathologically the tumor consisted of spindled and epitheloid
cells. Immunohistochemically the tumor cells displayed positivity
for S-100, HMB-45 and Melan-A. Findings were consistent with
malignant melanoma.
Discussion: Mucosal malignant melanomas have a poor prognosis
despite chemotherapy and radiotherapy. Five-year survival for
sinonasal melanoma is reported to be lower than 35%. Sinonasal
melanomas show a high recurrence rate. The immunohistochemical
markers showing high specificity for malignant melanoma such as
S-100, HMB-45 and Melan-A are used in order to reach a correct
diagnosis. In our case the tumor showed recurrence and multiple
metastases 1 year after completion of radiotherapy. For this recurrent
tumor, chemotherapy and radiotherapy have been planned.
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