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. 2017 May 5;34(3):255-262.
doi: 10.4274/balkanmedj.2016.0503. Epub 2017 Apr 6.

Primary Sinonasal Malignant Melanoma: Effect of Clinical and Histopathologic Prognostic Factors on Survival

Sercan Göde  1 , Göksel Turhal  1 , Ceyda Tarhan  1 , Banu Yaman  2 , Gülşen Kandiloğlu  2 , Kerem Öztürk  1 , İsa Kaya  1 , Raşit Midilli  1 , Bülent Karcı  1
Affiliations

Primary Sinonasal Malignant Melanoma: Effect of Clinical and Histopathologic Prognostic Factors on Survival

Sercan Göde et al. Balkan Med J. .

Abstract

Background: Mucosal melanoma is a rare malignancy arising from melanocytes of the mucosal surfaces. The pattern and frequency of oncogenic mutations and histopathological biomarkers have a role on distinct tumour behaviour and survival.

Aims: To assess the rate of C-KIT positivity and its effect on survival of surgically treated sinonasal malignant melanoma patients with other histopathological biomarkers and clinical features.

Study design: Retrospective cross-sectional study.

Methods: Seventeen sinonasal malignant melanoma patients with a mean age of 65.41 (39-86) years were included. Overall survival and disease-specific survival rates were calculated. The impact of age, gender, stage and extent of the disease, type of surgery, and adjuvant therapies were also taken into consideration. The effect of mitotic index, pigmentation, S100, HMB-45, Melan-A and C-KIT on survival were evaluated.

Results: Median tumour size was 20 mm (interquartile range=27.5 mm). Pigmentation was present in 7 (41.2%) cases. Median number of mitoses per millimetre squared was 11 (interquartile range=13). Melan A was positive in 7 (41.2%) patients, ulceration was present in 6 cases (35.3%), and necrosis was present in (47.1%) 8 cases. Six patients (35.3%) were positive for S100, 14 (82.4%) specimens stained positive for HMB-45 and C-KIT (CD117) was positive in 9 cases (52.9%). Three patients (16.7%) developed distant metastasis. Five year overall and disease free survival rates were 61.4% and 43.8%, respectively.

Conclusion: Although C-KIT positive sinonasal malignant melanoma patients (52.9%) can be candidates for targeted tumour therapies, the studied clinical or histopathological features along with C-KIT seem to have no significant effect on survival in a small group of patients with sinonasal malignant melanoma.

Keywords: C-KIT; Malignant melanoma; nasal cavity; paranasal sinuses; sinonasal malignancy mucosal melanoma..

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1. Pigmented spindle cell melanoma (H&E, 100x magnification) (a), cluster of epithelioid mucosal malignant melanoma under the mucosa (H&E 200x magnification) (b), focal melanin pigment is demonstrated on the left upper corner in a spindle cell tumour (H&E 200x magnification (c) and mucosal malignant melanoma with ulceration (H&E 200x magnification) (d).
Figure 2
Figure 2. The images at 200x magnification (a) and x100 magnification (b) show immunohistochemical staining for C-KIT (CD117).
Figure 3
Figure 3. Five year overall survival.
Figure 4
Figure 4. Survival according to C-KIT positivity.
Figure 5
Figure 5. Multiple skip lesions are clearly seen on the resection material (Arrows indicate skip lesions).
See this image and copyright information in PMC

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