Onkológia 3/2013

The role of radiation therapy in the treatment of malignant melanoma in the nasal cavity and nasopharynx – case report

Purpose: Primary mucosal malignant melanoma of the nasal cavity, paranasal sinuses, and nasopharynx (hereinafter referred to collectively as the sinonasal tract, i.e., sinonasal tract mucosal malignant melanomas [SNMMs]) is rare, accounting for between 0.3% and 2% of all malignant melanomas and about 4% of head and neck melanomas. Surgery is the treatment of choice for sinonasal mucosal malignant melanomas, especially complete resection of the tumor with sufficient free margins. Radiotherapy has controversial role in the treatment. Melanoma cells are traditionally considered as radioresistant because they have a high capacity for repair of sublethal damages, in particular when we used a conventional fractionation. Therefore, hypofractionation considered as a reasonable treatment regimen for this disease. Case: In this paper, we have reported the patient with intranasal cavity malignant melanoma. Functional endoscopic sinus surgery was performed to excise the nasal cavity tumor. However, using positron emission tomography/computed tomography scan with fluorodeoxyglucose was diagnosed residual nasopharyngeal tumor. Then, intracavitary brachytherapy for nasopharynx was further administered. Solitary metastatic cervical nodal involvement which was completely removed has been occurred 6 months after the end of brachytherapy. Even with the regional disease progression, we used external radiation therapy, as a modality of treatment. Conclusion: We decided to show this case report because of its rarity and the possible use of radiotherapy.

Keywords: malignant melanoma, nasal cavity, nasopharynx, radiotherapy.