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Head and neck pathology
Sep, 2022;16 (3): 942-946.

Nasal Mucosal Desmoplastic Melanoma: A Case Report with Review of the Literature.

Carlos A Ortega, Madelyn N Stevens, James S Lewis, Michael C Topf
Author Information
  1. Carlos A Ortega: Vanderbilt University School of Medicine, 37212, Nashville, TN, United States.
  2. Madelyn N Stevens: Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Avenue South, 7209 Medical Center East South Tower, 37232-8605, Nashville, TN, United States.
  3. James S Lewis: Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Avenue South, 7209 Medical Center East South Tower, 37232-8605, Nashville, TN, United States.
  4. Michael C Topf: Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1215 21st Avenue South, 7209 Medical Center East South Tower, 37232-8605, Nashville, TN, United States. michael.topf@vumc.org. ORCID
PMID: 35257324 DOI: 10.1007/s12105-022-01429-6

Abstract

Mucosal melanoma is a rare subtype of melanoma that accounts for 1% of all melanomas. The incidence of nasal mucosal melanomas is 0.3 per million. Desmoplastic melanomas are a subtype of melanoma with a reported incidence of 2.0 per million. Although 50% of desmoplastic melanomas are found in the head and neck region, mucosal desmoplastic melanoma is exceedingly rare. In the present study, we report a case of nasal mucosal desmoplastic melanoma and review the literature. A 79-year-old female presented to an outside otolaryngologist with nasal discomfort accompanied by rhinorrhea and was found to have a nasal vestibule mass. An endonasal incisional biopsy was performed yielding a diagnosis of a SOX-10 positive tumor. The patient was referred to our institution for further management. A blue-tinged lesion was identified at the prior biopsy site, and the mass was resected via an open rhinoplasty approach. Final pathology demonstrated an infiltrative spindle cell neoplasm with immunohistochemical patterns supportive of desmoplastic melanoma arising from the nasal vestibule. Due to positive margins, the patient underwent a re-resection with no tumor identified on the re-resected specimen. To our knowledge, this is the third case of nasal mucosal desmoplastic melanoma. We review the clinicopathologic features and management of this rare entity.

Keywords

(MeSH): Melanoma/pathology Immunohistochemistry Melanoma/classification Melanoma/epidemiology Melanoma/surgery Nasal Mucosa/pathology Nose Neoplasms/classification Nose Neoplasms/epidemiology Nose Neoplasms/pathology Nose Neoplasms/surgery

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MeSH Term

Aged
Female
Humans
Melanoma
Nasal Mucosa
Nose Neoplasms
Case Reports Journal Article Review
Article has an altmetric score of 3

Word Cloud

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