Toward a better understanding of sinonasal mucosal melanoma: clinical review of 23 cases.

BACKGROUND Primary sinonasal mucosal melanoma is a rare disease, occurring far less often than cutaneous lesions. The objective of this study was to review the records of patients diagnosed with primary sinonasal mucosal melanoma. METHODS We performed a retrospective review of the medical records of 23 patients with sinonasal mucosal melanoma who were treated at Taipei Veterans General Hospital between 1982 and 2002. RESULTS Sixteen of the 23 patients were male and 7 were female; their mean age was 68.2 years (range, 39-87 years). At diagnosis, the melanoma was limited to lesions located in the sinonasal area in 20 patients, and had spread in 3 patients. Local recurrence developed in 9 patients, neck metastasis in 5, and distant metastasis in 19. The 5-year disease-specific survival and local control rates were 22.26% and 52.30%, respectively. CONCLUSION In our experience, primary sinonasal mucosa melanoma is prone to spread from the site of origin. The major obstacle in improving overall survival is achieving systemic control.