Clinical Features and Treatment Outcomes of Mucosal Malignant Melanomas of Nasal Cavity and Paranasal Sinuses

Hong, Sung Lyong; Kim, Si Whan; Won, Tae Bin; Shim, Woo Sub; Kim, Yong Min; Kim, Jeong Whun; Lee, Chul Hee; Min, Yang Gi; Rhee, Chae Seo

Abstract

BACKGROUND AND OBJECTIVES
Mucosal malignant melanoma of the nasal cavity and paranasal sinuses is an uncommon tumor with poorer prognosis compared with its cutaneous counterpart. The purpose of this study is to investigate the clinical features and treatment outcomes of mucosal malignant melanoma of the nasal cavity and paranasal sinuses.
SUBJECTS AND METHOD
Eighteen patients who were diagnosed and treated as mucosal malignant melanoma of nasal cavity and paranasal sinuses from 1995 to 2004 were included. Male to female ratio was 10 to 8. Their ages ranged from 43 to 87 years with median of 62 years. The medical records were reviewed retrospectively with respect to presenting symptoms, stage, treatment modalities and outcome. RESULT: The most common symptoms were epistaxis and nasal obstruction. The mean duration of symptom was 4.2 months. Commonly involved sites were middle turbinate, inferior turbinate, maxillary sinus and ethmoid sinus. Eight cases belonged to stage I, nine cases to stage II and only one case to stage III. Among them, seventeen patients underwent surgery with or without radiotherapy and immunotherapy. Of the seventeen patients who underwent surgery, twelve had recurrence and the mean period for recurrence was 8.2 months. During the follow-up periods, five had distant metastases. Five-year survival rate was 27.2% and the survival rates according to age, sex, tumor size and stage were not statistically significant.
CONCLUSION
Mucosal malignant melanomas of the nasal cavity and paranasal sinuses developed commonly in the 6th to 8th decades. Epistaxis and nasal obstruction were the most common presenting symptoms. Almost all cases belonged to the stage I or II and the mainstay of the treatment was surgery. However, it was associated with frequent recurrences and a poor prognosis.