Malignant Mucosal Melanoma of the Maxillary Sinus with Oro-Antral Fistula

Abstract

Introduction – Sinonasal mucosal melanomas are uncommon, making up merely 0.5-2% of all malignant melanomas and 4% of melanomas in head and neck region. In the sinonasal region, they are very aggressive, commonly presenting at an advanced stage. Diagnosis is made using histopathological examination and immunohistochemistry by S100 and HMB-45 markers.

Case Report - We describe a case of 62 years’ female with swelling in the maxillary area and an oroantral fistula at the right maxillary alveolus who underwent right endoscopic sinus surgery with septoplasty with partial medial maxillectomy and oroantral fistula closure which was diagnosed as malignant melanoma on histopathology and immunohistochemistry.

Discussion – Malignant mucosal melanoma is a rare but aggressive disease originating from melanocytes located in the mucosa. It is characterised by swift nonspecific symptom progression and early metastasis. When the tumour is detected early and fully excised, malignant melanomas are majorly curable. However, once metastasis occurs, treatment options are limited.