Nasopharyngeal melanoma: clinical case

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Miriam del Carmen Marrero R.
María Sandra Domínguez S.
María Soledad Cabrera R.
Sergio Miranda F.
Marta González V.

Keywords

Mucosal melanoma, endoscopic surgery, tube rim, nasofibroscopy, epistaxis

Abstract

Primary mucous melanoma (MM) of the nasal cavity and paranasal sinuses remains a rare malignancy. The peak of incidence is between 50 and 60 years old, being epistaxis and unilateral nasal obstruction the most frequent symptoms. Surgical resection is the primary treatment with radiotherapy and adjuvant chemotherapy if necessary, the prognosis de- pends on the spreading. We present the case of an 81-year-old female patient attending for hemoptysis and halitosis of a year of evolution. The nasofibrolaryngoscopy showed a brownish, excrescent, irregular and friable lesion, outgrowth of the right tube rim. His- topathology result was nasopharyngeal MM. Immunohistochemical profile: S100 +, Me- lanA +, HMB45 +, SOX10 +, AE1AE3 negative. PET-CT showed a hypercaptation at the level of the right tube rim, without evidence of adenopathies or distant metastases. Complete tumor resection was performed by endoscopic surgery. Melanoma Oncology Committee decided no need of adjuvant therapy due to the complete resection of the lesion and considering the age and cognitive deterioration of the patient.

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