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Clinical Problem Solving: Radiology
November 2005

Radiology Quiz Case 1: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2005;131(11):1027. doi:10.1001/archotol.131.11.1027

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.