Clinical Analysis And Literature Review Of Sinonasal Malignant Melanoma

Objective: To investigate the clinical characteristics and treatment of sinonasal malignant melanoma.Methods: We retrospectively analyzed the clinical data of 20 cases of sinonasal malignant melanoma treated with Department of Otolaryngology head and neck surgery in the First Affiliated Hospital of Bengbu Medical College from January 2000 to December 2015,and reviewed the relevant literature research data in recent years.sinonasal malignant melanoma clinical features,diagnosis,staging,treatment were discussed and analyzed.Results: According to the 7th edition of AJCC stage,11 cases in stage Ⅲ,9cases in stage Ⅳa.11 cases underwent surgery plus adjuvant chemotherapy,the other 9 patients were treated with a combination treatment scheme of adding biological therapy.All patients were followed up.In 11 cases group:1 year survived in 9 cases,the survival rate was 40.3%(9/11);3 years survived in 4 cases,the survival rate was 40.0%(4/10);5years survived in 1 case,the survival rate of 20%(1/5);1 case survived till now.The patient died of local recurrence and / or distant metastasis.Local recurrence in 6 cases,local recurrence rate was 54.55%(6/11),5 cases died.5 cases of distant metastasis,distant metastasis rate was 45.45%(5/11),of which 2 cases of liver metastasis,2 cases of brain metastasis,1 case of lung metastasis,5 cases died.In 9 cases group:1 year survived in 9 cases,the survival rate was 100%(9/9);3 years survived in 5 cases,the survival rate was 62.5%(5/8);5 years survived 1 case,the survival rate 33.33%(1/3);2cases survived till now,of which,1 case have survived for up to 15 years.Local recurrence in 4 cases,Local recurrence rate was 44.44%(4/9),4 cases died.3 cases of distant metastasis,distant metastasis rate was 33.33%(3/9),of which 1 case of liver metastasis,1 case of brain metastasis,1 case of lung metastasis,3 cases died.Conclusion: 1.Early diagnosis and radical resection are still important prognostic factors of sinonasal malignant melanoma.In the elderly patients with persistent unilateral nasal obstruction and intermittent nasal bleeding symptoms,according to the relevant imaging and endoscopic findings should be suspected of sinonasal malignant melanoma may.The disease was finally confirmed by pathology and immunohistochemistry could be used for differential diagnosis.2.The 7th Edition AJCC head and neck mucosa malignant melanoma.TNM staging may be more suitable forsinonasal malignant melanoma.The group of 20 cases: stage Ⅲ11cases,Ⅳa 9cases.In 11 cases group: The 1-year,3-year,5-year survival rates were83.33%(9/11),40.00%(4/10),20%(1/5).In 9 cases group: The survival rates were100%(9/9),62.50%(5/8)and 33.33%(1/3).3.The clinical comprehensive treatment scheme is diverse,and it is recommended that radiotherapy + operation + chemotherapy + biological therapy.