Fusetti Marco, Eibenstein Alberto, Lupi Ettore, Iacomino Enzo, Pieramici Tiziana, Fioretti Alessandra
Department of Applied Clinical Sciences, University of L'Aquila, Viale S. Salvatore, Edificio 6, Ingresso A, Fraz. Coppito, 67100 L'Aquila, Italy.
Ear Nose Throat J. 2014 Jan;93(1):E1-5.
We describe a case of mucosal malignant melanoma in the sinonasal area of a 65-year-old woman. She presented with a history of nasal obstruction and epistaxis with subsequent tenderness, facial anesthesia involving cranial nerve V2, red eye, proptosis, diplopia, and conjunctival chemosis. Computed tomography detected a nonspecific solid mass that had involved the left maxillary sinus and surrounding tissues, with extension into the nasal cavity and invasion of the orbital floor and eye muscles. Histopathologic examination of the neoplasm revealed that it was a malignant melanoma. We performed a radical hemimaxillectomy that extended to the orbit, which allowed for radical excision of the tumor. Postoperatively, the patient received adjuvant chemotherapy and radiotherapy. Mucosal melanoma in the head and neck is a rare and highly malignant neoplasm. We suggest that malignant melanoma be suspected when a small-round-cell tumor is found on light microscopy, and we confirm the usefulness of immunohistochemical investigations.
我们描述了一例65岁女性鼻窦区黏膜恶性黑色素瘤的病例。她有鼻塞和鼻出血病史，随后出现压痛、累及颅神经V2的面部麻木、眼红、眼球突出、复视和结膜水肿。计算机断层扫描检测到一个非特异性实性肿块，累及左上颌窦及周围组织，延伸至鼻腔，侵犯眶底和眼肌。肿瘤的组织病理学检查显示为恶性黑色素瘤。我们进行了扩大至眼眶的根治性半侧上颌骨切除术，从而实现了肿瘤的根治性切除。术后，患者接受了辅助化疗和放疗。头颈部黏膜黑色素瘤是一种罕见且高度恶性的肿瘤。我们建议，当在光学显微镜下发现小圆细胞瘤时应怀疑为恶性黑色素瘤，并且我们证实了免疫组织化学检查的实用性。
