Imaging Features And Prognostic Factors Of The Malignant Melanoma Of The Nasal Cavity And Sinuses

Objective: To explore and determine prognostic factors and outcomes of patients with malignant melanomas arising from nasal cavity and paranasal sinus.To investigate the imaging features of sinonasal malignant melanomas.Methods: Clinical information and imaging findings of 36 patients with SNMM in Xinhua Hospital from January 2008 to December 2017 were retrospective analyzed.Summarize basic clinical data,imaging features,the treatment process.The outcomes and the prognosis were followed up.The prognostic factors were compared and discussed.Results: Of 36 patients with SNMM,17 of them were male,19 were female,the average age of patients was 67.39±10.82.The main clinical symptoms was epistaxis(72.22%),nasal obstruction,hyposmia and maxillofacial pain.Melanin pigment was detected in 15 cases with magnetic resonance enhancement examination.According to the SNMM TNM staging system: 8 patients were stage Ⅲ;20 patients were stage Ⅳa;4 patients were stage Ⅳb and 4 patients were stage Ⅳc.The main treatment was endoscopic resection of sinonasal neoplasms.8 patients with lymph node metastasis underwent neck lymph node dissection.The mortality rate during follow-up was 44.44%,and the recurrence rate was 27.78%.In this series,the overall 1,3,5-year survival rate was 80.56%,36.11%,13.89%.Conclusions:SNMM is a rare malignant disease with poor prognosis.Specific imagine feature of malignant melanomas is detected in some cases which shows hyperintense on T1 WI and hypointense on T2 WI,the prognosis has no significant difference between the two groups.The prognosis is closely related to TNM stage.Tumors origin from paranasal sinus have poorer prognosis,and patients receiving endoscope surgery has better prognosis than open surgery.Adjuvant therapy did not significantly improve the overall prognosis.