[Melanoma of the nasal fossae and sinuses, apropos of a series of 7 cases]

Abstract

The authors present their experience of the malignant, mucosal melanomas involving the nasal cavity and paranasal sinuses through a retrospective study of 7 cases, observed in Rouen from 1977 to 1988. The results are compared to a review of world literature. The mucosal melanoma of the nose and sinus is a rare entity, representing approximatively 40 per cent of all sinonasal neoplasias. The signs and symptoms of sinonasal melanomas are non-specific. Therefore, the diagnosis is often delayed. The histological diagnosis is difficult given the substantial polymorphism of these tumors and the experience of achromatous forms. Electron microscope study and immuno-histo-chemical techniques using various monoclonal antibodies make it possible to eliminate the other major, differential diagnoses. Surgery is the primary method of treatment, sometimes combined with adjunctive postoperative radiotherapy. More recently, combined treatment with interferon and cimetidine appears to be interesting. The prognosis is very poor, if compared to skin melanomas, with a five year survival rate of 5 to 30 per cent. Local recurrence at the primary site and distant metastases are the most common caused of treatment failure.