title: Mucosal Malignant Melanoma of Nasal Cavity Recurring a Year After Radiotherapy.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pathology, Yakın Doğu University, Faculty of Medicine, LEFKOŞA, TURKİSH REPUBLIC of NORTHERN CYPRUS.
authors.forename: Cem
authors.initials: C
authors.lastname: Çomunoğlu
authors.forename: Gamze Mocan
authors.initials: GM
authors.lastname: Kuzey
authors.forename: Mete
authors.initials: M
authors.lastname: Inançli
authors.forename: Füsun
authors.initials: F
authors.lastname: Baba
authors.forename: Hanife
authors.initials: H
authors.lastname: Özkayalar
mesh_terms: D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy*; D009297:Nasal Mucosa / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D014408:Biomarkers, Tumor