Endonasal tumor and right hip fracture as clinical presentation of a case of sinonasal mucosal melanoma

Abstract

The mucosal melanoma is considered a distinct subtype of cutaneous melanoma. The 40%-50% of cases of mucosal melanomas is located in the head and neck, the most common are found in sinonasal level and in the oral cavity; in the anterior portion of the nasal septum and the inferior and middle turbinates. Those neoplasms originate from the malignant cells found in the mucosa and submucosa. Usually are lately diagnosed, with distant metastases. If suspicious unilateral sinonasal manifestations appears is extremely important to realize an exhaustive exploration of superior aerodigestive vias and a histopathological examination of the lesion. We present a 56 year old with repeated epistaxis of several months of duration. The examination revealed a polypoid tumor occupying the entire right nostril, septal deviation and deformity of the nasal pyramid. Pathological studies reports infiltrating malignant melanoma. During the hospitalization the patient has difficulty walking and pain in the right hip, being diagnosed by Traumatology of fracture basicervical. During the surgery, a bone fragment hip is sent for anathomopathology study which is reported as bone tissue injury support substrate metastasized malignant cell proliferation by immunophenotype and morphology of melanoma.