Scepanovic Danijela, Paluga Marek, Rybnikarova Michaela, Pobijakova Margita, Masarykova Andrea, Kroslak Milan
Radiation Oncology Department, National Oncology Institute of Slovakia, Bratislava.
J Contemp Brachytherapy. 2013 Sep;5(3):157-63. doi: 10.5114/jcb.2013.37404. Epub 2013 Sep 12.
Primary malignant melanoma of the nasal cavity and nasopharynx is rarely seen. Clinically, most patients display initial nonspecific symptoms of unilateral nasal obstruction or epistaxis. The prognosis is generally poor, with a mean survival time of 3.5 years.
In this paper, we have reported the case of malignant melanoma of the nasal cavity and nasopharynx. 79 years old man had presented with the swelling of the nose, nasal blockage and epistaxis during the six months before diagnosis. Functional endoscopic sinus surgery was performed to excised the nasal cavity tumor. Using positron emission tomography/computed tomography examination with 18-fluorodeoxyglucose, the patient was diagnosed with residual nasopharyngeal tumor after surgery.
Following the diagnosis, intracavitary brachytherapy for nasopharynx was administered. Solitary cervical nodal involvement occurred 6 months after the diagnosis when had been completely removed. After that, external beam radiotherapy was performed on the submandibular area on the right side. Thereafter, the patient was given follow-up care in the Department of Radiation Oncology until the time of distant progression of the disease.
We have chosen to discuss this condition, because of its rarity and the possibility of using radiotherapy, even though the malignant melanoma had been regarded as a radioresistant disease, and also to emphasize the importance of a multidisciplinary approach to treatment of such patients.
鼻腔和鼻咽部原发性恶性黑色素瘤较为罕见。临床上，大多数患者最初表现为单侧鼻塞或鼻出血等非特异性症状。预后通常较差，平均生存时间为3.5年。
本文报告了1例鼻腔和鼻咽部恶性黑色素瘤病例。一名79岁男性在诊断前6个月出现鼻部肿胀、鼻塞和鼻出血。行功能性鼻内镜鼻窦手术切除鼻腔肿瘤。通过18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描检查，患者术后被诊断为鼻咽部肿瘤残留。
确诊后，对鼻咽部进行腔内近距离放射治疗。诊断6个月后出现孤立性颈部淋巴结转移，已将其完全切除。此后，对右侧下颌下区进行了体外放射治疗。此后，患者在放射肿瘤学部门接受随访，直至疾病远处进展。
我们选择讨论这种情况，是因为其罕见性以及即使恶性黑色素瘤被认为是一种放射抗拒性疾病仍有可能使用放射治疗，同时也是为了强调多学科方法治疗此类患者的重要性。
