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Arch Otolaryngol Head Neck Surg. 2005;131:1027.

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Diagnosis: Melanotic-type mucosal malignant melanoma (MMM)

A biopsy specimen of the dark–brown-black mass in the nasopharynx revealed melanotic-type MMM. Malignant melanoma of the paranasal sinus region is extremely rare.^1-2 In a series of 158 cases of mucosal melanoma of the upper airways, Batsakis et al³ reported only 1 case that was located in the nasopharynx. Upper airway melanomas represent 0.5% to 1.5% of all melanomas and 3.5% of tumors of the paranasal sinuses. The highest incidence occurs between the fifth and eighth decades of life, with no sex predilection.^2-3 The predominant symptoms of MMM of the paranasal region are epistaxis and nasal obstruction.^{1, 3} However, as in our case, a lump in the neck can sometimes be the first sign of disease.

More than two thirds of MMMs contain identifiable melanin pigment. This type of tumor is called the melanotic-type MMM. However, when melanin is sparse, as in the amelanotic type, the MMM may be misdiagnosed as . . . [Full Text of this Article]

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