Malignant mucosal melanoma in the nasal cavity: an uncommon cause of epistaxis.

Malignant mucosal melanoma of the nasal cavity is extremely rare. It is usually diagnosed in the elderly. We report a 78-year-old man who had symptoms of occasional episodes of epistaxis and blood-tinged sputum for about 1 month. Physical examination showed a dark-colored mass lesion over the left nasal cavity, and biopsy of it revealed malignant melanoma. Wide excision of the tumor was performed via endoscopic surgery, and adjuvant radiotherapy was also arranged. Diagnosis of malignant melanoma mainly depends on histochemistry and immunostain. Up to now, surgery offers the best chance for local tumor control. However, postoperative radiotherapy or chemotherapy is often needed because mucosal melanomas tend to have distant metastasis and local failure. Immunotherapy may play a role in improving outcome, but evidence is lacking.