Recurrent amelanotic melanoma of nasal cavity: Biological variability and unpredictable behavior of mucosal melanoma. A case report

  • Damir Vučinić | damir.vucinic@gmail.com Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
  • Dag Zahirović Department of Radiotherapy and Oncology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
  • Dubravko Manestar Faculty of Medicine, University of Rijeka; Clinic of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
  • Ingrid Belac-Lovasić Faculty of Medicine, University of Rijeka; Department of Radiotherapy and Oncology, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
  • Tamara Braut Faculty of Medicine, University of Rijeka; Clinic of Otorhinolaryngology, Head and Neck Surgery, Clinical Hospital Centre Rijeka, Rijeka, Croatia.
  • Leo Kovač Department of Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
  • Nives Jonjić Department of Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
  • Gordana Zamolo Department of Pathology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.

Abstract

The aim of this report is to present a case of a patient with a recurrent nasal cavity amelanotic melanoma (AM), with emphasis on diagnosis and therapy options of this clinical entity. A 65-year-old female patient presented with pain in the right cheek region and nasal obstruction. In 2013, she was diagnosed with mucosal melanoma (MM) of the left nasal cavity. After endoscopic surgery and radiotherapy, the patient was followed by the oncology team. Five years after the initial diagnosis, rhinoscopy showed a tumorous formation in the right nasal cavity. The tumor mass was without black discoloration and was the same color as the surrounding nasal mucosa. Microscopic examination after biopsy of the tumor confirmed amelanotic MM. The patient underwent an additional endoscopic surgery. A complete standard diagnostic workup for MM found metastases in head and neck lymph nodes, on both sides. MMs of head and neck are uncommon malignancies. Unique biology of MM cells causes a high rate of recurrences. This report presents an example of recurrent AM of the nasal cavity, in treatment with checkpoint inhibitor (pembrolizumab), which could provide a good therapy option for patients with MM.

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Published
2019-06-11
Section
Case Reports
Keywords:
Amelanotic melanoma, Nasal cavity, Mucosal melanoma, Immunotherapy, Radiotherapy
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How to Cite
Vučinić, D., Zahirović, D., Manestar, D., Belac-Lovasić, I., Braut, T., Kovač, L., Jonjić, N., & Zamolo, G. (2019). Recurrent amelanotic melanoma of nasal cavity: Biological variability and unpredictable behavior of mucosal melanoma. A case report. Clinics and Practice, 9(2). https://doi.org/10.4081/cp.2019.1157