Display options
Cite
Azoury SC, Crompton JG, Straughan DM, et al. Unknown primary nasopharyngeal melanoma presenting as severe recurrent epistaxis and hearing loss following treatment and remission of metastatic disease: A case report and literature review. Int J Surg Case Rep. 2015;10:232-5doi: 10.1016/j.ijscr.2015.03.053.
Azoury, S. C., Crompton, J. G., Straughan, D. M., Klemen, N. D., Reardon, E. S., Beresnev, T. H., & Hughes, M. S. (2015). Unknown primary nasopharyngeal melanoma presenting as severe recurrent epistaxis and hearing loss following treatment and remission of metastatic disease: A case report and literature review. International journal of surgery case reports, 10232-5. https://doi.org/10.1016/j.ijscr.2015.03.053
Azoury, Saïd C, et al. "Unknown primary nasopharyngeal melanoma presenting as severe recurrent epistaxis and hearing loss following treatment and remission of metastatic disease: A case report and literature review." International journal of surgery case reports vol. 10 (2015): 232-5. doi: https://doi.org/10.1016/j.ijscr.2015.03.053
Azoury SC, Crompton JG, Straughan DM, Klemen ND, Reardon ES, Beresnev TH, Hughes MS. Unknown primary nasopharyngeal melanoma presenting as severe recurrent epistaxis and hearing loss following treatment and remission of metastatic disease: A case report and literature review. Int J Surg Case Rep. 2015;10:232-5. doi: 10.1016/j.ijscr.2015.03.053. Epub 2015 Apr 01. PMID: 25898283; PMCID: PMC4430121.
Copy Download .nbib Format: NLM
Share it on

Int J Surg Case Rep. 2015;10:232-5. doi: 10.1016/j.ijscr.2015.03.053. Epub 2015 Apr 01.

Unknown primary nasopharyngeal melanoma presenting as severe recurrent epistaxis and hearing loss following treatment and remission of metastatic disease: A case report and literature review.

International journal of surgery case reports

Saïd C Azoury, Joseph G Crompton, David M Straughan, Nicholas D Klemen, Emily S Reardon, Tatiana H Beresnev, Marybeth S Hughes

Affiliations

  1. Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; Department of Surgery, The Johns Hopkins Hospital, Johns Hopkins University, School of Medicine, USA. Electronic address: [email protected].
  2. Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
  3. Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., USA.

PMID: 25898283 PMCID: PMC4430121 DOI: 10.1016/j.ijscr.2015.03.053

Abstract

INTRODUCTION: Primary nasopharyngeal melanoma is an exceedingly rare pathology with unclear etiology and oftentimes obscure clinical presentation. Despite improved diagnostic capabilities, these lesions are often diagnosed at an advanced stage and associated prognosis is poor, partly due to high rates of recurrences and metastasis.

PRESENTATION OF CASE: A 74-year-old woman was diagnosed with metastatic melanoma to the liver, of unknown primary. Just prior to the time of diagnosis, she experienced several episodes of severe epistaxis which she managed conservatively. Her symptoms eventually subsided without further medical evaluation. The patient was initially treated with interleukin-2 (IL-2) for her advanced disease, but her cancer progressed. She was then enrolled in a protocol for percutaneous hepatic perfusion (PHP) with melphalan and had complete radiographic resolution of disease, yet her nosebleeds recurred and persisted despite conservative measures. Six years after her initial diagnosis, a nasopharyngoscopy demonstrated a pigmented lesion in the posterior nasopharynx. Surgical resection was performed (pathology consistent with mucosal melanoma) followed by radiation therapy. She has since had complete resolution of bleeding and shows no evidence of cancer.

DISCUSSION: To our knowledge, this is the first report of a diagnosis of primary nasopharyngeal melanoma 6-years following complete remission of metastatic disease. Surgery remains the primary treatment for disease and symptom control in this setting.

CONCLUSION: Timely diagnosis of nasopharyngeal melanomas remains challenging. Thorough clinical evaluations should be performed in such patients, and attention should be paid to recurrent and persistent symptoms, such as epistaxis and hearing loss. This may allow for earlier detection of primary disease.

Published by Elsevier Ltd.

Keywords: Head and neck; Melanoma; Metastasis; Mucosal; Nasopharyngeal

References

  1. Head Neck Surg. 1982 May-Jun;4(5):404-18 - PubMed
  2. J Clin Oncol. 2000 Nov 15;18(22):3782-93 - PubMed
  3. Otolaryngol Head Neck Surg. 2008 Mar;138(3):347-52 - PubMed
  4. Arch Otolaryngol Head Neck Surg. 2003 Aug;129(8):864-8 - PubMed
  5. Oral Oncol. 2008 Nov;44(11):1039-46 - PubMed
  6. Am J Surg Pathol. 2003 May;27(5):594-611 - PubMed
  7. Head Neck. 2008 Dec;30(12):1543-51 - PubMed
  8. Head Neck. 2016 Jan;38(1):147-55 - PubMed
  9. Cancer. 1997 Oct 15;80(8):1373-86 - PubMed
  10. Am J Clin Oncol. 2015 Feb;38(1):87-9 - PubMed
  11. Melanoma Res. 1992 Jul;2(2):101-4 - PubMed
  12. J Skin Cancer. 2012;2012:231693 - PubMed
  13. Arch Otolaryngol Head Neck Surg. 1997 Mar;123(3):290-6 - PubMed
  14. Oral Oncol. 2000 Mar;36(2):152-69 - PubMed
  15. Ann Surg Oncol. 2011 Oct;18(10):2748-56 - PubMed
  16. Surg Clin North Am. 2014 Oct;94(5):945-62, vii - PubMed
  17. J Craniomaxillofac Surg. 2012 Apr;40(3):266-70 - PubMed
  18. BMC Cancer. 2014 Aug 23;14:608 - PubMed
  19. J Clin Oncol. 2005 May 20;23(15):3465-74 - PubMed
  20. Head Neck Pathol. 2012 Jun;6(2):184-90 - PubMed

Publication Types