Unfortunately, achieving long-term local control remains elusive with local recurrence rates of approximately 50%.įurther, despite a relatively low rate of regional lymph node metastasis at presentation, cervical metastasis complicates the clinical course of disease in approximately 20 to 40% of cases and is often associated with local or distant recurrence. The majority of sinonasal melanomas present with localized disease, with only 5 to 20% of cases presenting with clinically detectable regional metastasis. In contrast to cutaneous melanoma, the prognosis of sinonasal melanoma is extremely poor with 5-year survivals generally less than 40% despite aggressive treatment. It represents approximately 1% of all melanomas and just 4 to 8% of all malignancies of the nasal cavity and paranasal sinuses. Sinonasal melanoma is a rare malignancy derived from melanocytes of the nasal mucosa. This intraoperative tool has the potential to improve detection of regional metastasis and improve long-term outcomes of this aggressive malignancy. Sentinel node biopsy for sinonasal melanoma can provide crucial clinical evidence of regional metastasis prior to overt clinical signs and symptoms. Metastatic melanoma was found in both nodes and completion lymphadenectomy was negative for additional disease.īoth patients developed distant metastasis in less than 1 year after surgical resection but responded well to adjuvant immunomodulatory chemotherapeutic agents. Lymphoscintigraphy with single-photon emission computed tomography (SPECT/CT) localization revealed one sentinel node in the parapharyngeal space and another in the ipsilateral cervical basin. Patient 2 (71F) presented after incomplete resection of a sinonasal melanoma of the left posterior maxillary sinus wall and was clinically N0 neck. The left level I sentinel node was positive for melanoma and lymphadenectomy showed no additional metastases. Lymphoscintigraphy revealed two sentinel nodes in the ipsilateral and three in the contralateral cervical basins. Patient 1 (83M) presented with a sinonasal melanoma anterior to the left inferior turbinate and was clinically N0 neck. Patients who underwent sentinel node biopsy for sinonasal melanoma between Novemand November 1, 2015. Report two positive sentinel node biopsies for sinonasal melanoma.
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