Recurrent sinonasal melanoma - report of five surgical cases and short literature review [Recidivirajući sinonazalni melanom - prikaz 5 slučajeva i kratki pregled literature]

Džepina, Davor and Kalogjera, Livije and Baudoin, Tomislav (2012) Recurrent sinonasal melanoma - report of five surgical cases and short literature review [Recidivirajući sinonazalni melanom - prikaz 5 slučajeva i kratki pregled literature]. Collegium Antropologicum, 36 (S. 2). pp. 179-184. ISSN 0350-6134

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Abstract

The aim of this study is to present five surgical cases of recurrent sinonasal melanoma. We report the clinical course of this highly malignant disease and give a brief overview of the relevant literature. For the purpose of our presentation, inclusion criteria for all patients were initally negative surgical margins, surgery with curative intent without implementation of radiotherapy, and absence of distant metastatic spread at presentation (MO). They were diagnosed and treated at the same ENT/Head and Neck Surgery department and had clear surgical margins following first resection. The majority of five cases had local recurrences (average two) which were all amenable to at least one salvage operation. In conclusion, despite extensive disease at presentation, we recommend repeated attempts at local surgical salvage. However, this decision must be carefully considered, respecting postoperative quality of life, the estimated life expectancy as well as general socioeconomic issues in each particular case.

Abstract in Croatian

Cilj ovog rada bio prezentirati 5 kirurških slučajeva recidivirajućeg melanoma nosa i paranazalnih sinusa, prikazati klinički tijek ove visoko maligne bolesti te dati kratki prikaz stručne literature. Za potrebe ove prezentacije kriteriji uključenja za sve pacijente bili su inicijalni kurativni kirurški zahvat bez implementirane radioterapije, odsutnošću udaljenih metastaza (M0) kod prezentacije bolesti, te negativne patološke granice ekscizije. Svi slučajevi su bili dijagnosticirani i operirani na Klinici za otorinolaringologiju te imali čiste kirurške rubove nakon prve resekcije tumora. Većina pacijenata imala je lokalne recidive bolesti (u prosjeku dva), koji su bili dostupni najmanje jednoj operaciji. Zaključno, unatoč lokalno proširenoj bolesti u najvećem broju slučajeva, preporučujemo pokušaj reoperacije kod pojave lokalnog recidiva sinonazalnog melanoma. Ipak, potrebna je pažljiva i detaljna procjena prije donošenja odluke o daljnjim operacijama recidiva, poštujući predvidjenu postoperativnu kvalitetu života, očekivanu specifičnu prognozu kao i općenito socijalno-ekonomsko stanje pacijenta u svakom pojedinačnom slučaju.

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