Abstract
Objectives:
Sinonasal melanoma (SNM) is a rare cancer with extremely poor prognosis. Detecting melanoma on frozen section has historically been considered to be unreliable. A review of cases of SNM treated at a tertiary referral center was conducted with emphasis on investigating the correlation between detecting melanoma on frozen section and permanent analysis.
Methods:
An institutional review board (IRB)-approved search of the pathology database for cases of primary SNM treated between 1991-2011 was performed. The medical charts were then reviewed.
Results:
Fourteen cases of SNM were identified. Eleven arose from the nasal cavity, 2 arose from the maxillary sinus, and 1 from bilateral ethmoids. At average follow-up period of 22 mos (2-85 mos), 13 patients were alive. Five cases were free of disease (NED), 6 had recurrent disease (RD), and 3 had unknown disease status. Patients with NED presented at an average age 67 years (47-82 years). On pathological analysis, average melanoma size was 5.2cm (2-9cm), all had clear margins, 2 had perineural invasion (PNI), and 1 had lymphovascular invasion (LVI). Four received adjuvant radiation (XRT). Of the RD patients, average age was 63.7 years. On pathologic analysis, average size of the tumor was 2.3cm (0.5-3.5cm); margin status was positive in 2, clear in 2, and not evaluated in 2 cases. Ten cases had evaluation of intraoperative frozen sections. When compared with final pathology, FS correlated with permanent section 100% cases. One had LVI with PNI, and 5 cases received XRT.
Conclusions:
Based on this series, intraoperative frozen section analysis of SNM correlates well with final pathology.
Get full access to this article
View all access options for this article.