title: Primary sinonasal malignant melanoma: a clinicopathologic and prognostic study.
abstract: We conducted a retrospective study to evaluate the clinicopathologic features and prognostic factors associated with primary sinonasal malignant melanoma. We reviewed the records of 10 patients-7 men and 3 women, aged 35 to 70 years (mean: 51.4)-who had been treated at our referral center over a 9-year period. The tumors were located in the nasal cavity in 7 patients and in a paranasal sinus in the other 3. Medial maxillectomy was performed in 4 patients, wide local excision in 3, and endoscopic excision in 2; the remaining patient, who had presented with a liver metastasis, received chemotherapy and palliative local radiotherapy. Two patients who presented with a neck node metastasis also underwent concurrent radical neck dissection. Follow-up ranged from 8 to 70 months (median: 25). Only 4 patients remained alive through the duration of follow-up. The 2- and 5-year survival rates were 60 and 40%, respectively. Based on the findings of our small study, we conclude that primary sinonasal malignant melanoma carries a generally poor prognosis despite aggressive treatment. The primary cause of death in our series was a distant metastasis (n = 5) despite adequate locoregional control in most cases. This finding confirms the aggressive nature of this disease. Other factors that appeared to be associated with a poor prognosis were (1) older age, (2) a primary tumor location in a paranasal sinus, (3) an advanced tumor stage, (4) an external approach to surgery, and (5) the absence of adjuvant radiotherapy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drsudeshkumar@rediffmail.com
authors.forename: Sudesh
authors.initials: S
authors.lastname: Kumar
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Gupta
authors.forename: Budhi S
authors.initials: BS
authors.lastname: Yadav
authors.forename: Sushmita
authors.initials: S
authors.lastname: Ghoshal
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate