Metastatic melanoma to the ethmoid sinus.

Malignant melanomas comprise approximately 1.5% of all malignant tumors and one fifth of these will involve the head and neck. The surgeon who operates in this region should be familiar with all aspects of this disease. The most common site of metastasis to the nose and paranasal sinuses is via the maxillary sinus. Often these metastases are of renal origin, with pulmonary metastases being the second most common source. The most frequent presenting symptoms are epistaxis, a nasal mass, or nasal obstruction. Review of the English literature to date has not revealed any reports of isolated metastatic melanoma to the ethmoid sinus. Batson, in 1940, proposed a plausible mechanism of such hematogenous metastasis via a valveless vertebral venous bed.