Primary mucosal melanoma of the nasal cavity and paranasal sinuses: 12 years of experience

Abstract

Introduction: Melanomas that arise in the nasal cavity or paranasal sinuses are rare and have a poor prognosis. In this study, we reviewed 15 patients in a tertiary referral centre and analyzed their treatment results and patterns of treatment failure.

Materials and methods: Fifteen patients diagnosed from January 1994 to February 2005 at the Chang Gung Memorial Hospital were retrospectively reviewed.

Results: Eight men (53.3%) and seven (46.7%) women ranged in age from 51 to 85 years (mean 69.0 years) at the time of diagnosis. All patients presented with symptoms related to the nose. The majority of patients presented with epistaxis (93.3%). Ten patients received surgery and postoperative radiotherapy, three patients received surgery and postoperative chemo- and radiotherapy, and one patient received radiotherapy alone. The overall actuarial survival revealed that 49.5% were alive at 2 years and 33.0% were alive at 5 years. The average time from surgery to local recurrence was 5 months, the average time from surgery to the occurrence of regional recurrence was 7.45 months, and the time from surgery to the diagnosis of distant metastasis was 10.3 months. The sites of distant metastasis according to frequency are the lung, liver, bone, and brain. The average survival after the diagnosis of distant metastasis was 8 months.

Conclusion: The prognosis of mucosal melanoma of the nasal cavity is poor in our experience. Most of the local recurrence, regional recurrence, and distant metastasis occurs in the first year after surgery. For those patients in the first year after surgery, frequent and regular follow-up is mandatory.