PDF(Pubmed)
Abstract：
Sinonasal malignant melanoma (SMM) is a rare malignant tumour among head and neck cancers predominantly found in adults 60 years and above. The commonly reported symptoms for sinonasal tumour lesions are nasal obstruction and recurrent, painless epistaxis as the symptoms are non-specific and can delay the diagnosis. Moreover, melanoma has a poor prognosis regardless of its location. We report an 86-year-old female patient presenting with recurrent, painless epistaxis from the nasal cavity. Anterior rhinoscopic examination revealed a bluish-black, bleeding mass completely obstructing the left nasal nare. Contrast-enhanced computed tomography of the nasal cavity and sinus region showed a polypoidal soft tissue attenuation with heterogeneous enhancement completely filling the left nasal cavity. The patient underwent endoscopic excision. Histopathology of the specimen showed a small, round and blue cell tumour which immunohistochemistry found to be positive for S100 and HMB 45. After surgical resection, the patient received chemotherapy and radiotherapy. Sinonasal malignant melanoma is a rare, aggressive tumour that has a very poor prognosis. Contrast-enhanced computed tomography of the nasal cavity and paranasal sinuses is the imaging modality of choice which reveals the enhancing mass. There is no optimal management strategy for SMM. Surgical resection is the first-line treatment but is limited due to the complex anatomy of the sinonasal region.
摘要：
鼻窦恶性黑色素瘤（SMM）是头颈部癌症中的一种罕见恶性肿瘤，主要见于60岁及以上的成年人。鼻窦肿瘤病变的常见症状是鼻塞和复发，无痛性鼻出血，因为症状是非特异性的，可以延迟诊断。此外，无论其位置如何，黑色素瘤的预后都较差。我们报告了一名86岁的女性患者，来自鼻腔的无痛性鼻出血。前鼻镜检查显示蓝黑色，出血量完全阻塞左鼻孔。鼻腔和鼻窦区域的对比增强计算机断层扫描显示息肉状软组织衰减，异质增强完全填充左鼻腔。患者接受了内镜切除术。标本的组织病理学显示，免疫组织化学发现S100和HMB阳性的圆形和蓝色细胞肿瘤45。手术切除后,患者接受了化疗和放疗。鼻窦恶性黑色素瘤是一种罕见的，侵袭性肿瘤，预后很差。鼻腔和鼻旁窦的对比增强计算机断层扫描是选择的成像方式，可显示增强的肿块。SMM没有最佳的管理策略。手术切除是一线治疗，但由于鼻窦区域的复杂解剖结构而受到限制。
