Rezidivierte, primär multifokale maligne Melanome der Schleimhäute des oberen Respirationstraktes

Abstract

We report on a patient who at 61 years of age presented with two nodular melanomas in the right nasal cavity. These tumors were limited to the mucosal membrane and were accompanied by a large amount of atypical hyperplasia of the melanocytes within the glandular and surface epithelium of various other samples of the mucous membrane, a finding also verified immunohistochemically. These tumors were treated surgically. In the clinical course, after a prolonged tumor-free interval, a malignant melanoma of the contralateral nasal cavity occurred, in addition to recurrences in the area of the primary tumor. It seems likely that the large, diffuse proliferation of atypical melanocytes observed could have been the starting point of both the tumor recurrences and the second primary. Thus, in a histologically proven melanoma in the mucous membranes of the upper respiratory system, a more intense preoperative histological diagnostic procedure, in given cases with the assistance of immunohistochemical methods, could be useful to demonstrate intraepithelial atypical melanocytes. It is possible that by doing this the present poor prognosis for mucosal melanomas of the upper respiratory tract might be improved.