Effective sequential chemoradiotherapy of a patient with locally advanced melanoma of the naso-ethmoidal massive

Abstract

Mucosal melanomas are rare neoplasms. They account for approximately 0.5–2% of all melanomas. The treatment of choice is radical surgical resection followed by radiotherapy and/or chemotherapy. 5-year survival rate in mucosal melanomas is only 17.1%. Case report: 54-year-old patient presented with a 50 × 36 mm mucosal melanoma located within the left maxillary sinus, ethmoid sinus and upper-middle part of the nasal cavity. Clinical stage of the disease was estimated to T4bN1M0. The patient was treated with chemotherapy (CT) according to the BOLD program: bleomycin 8 mg/m², vincristine 1 mg/m², lomustine 44 mg/m², dacarbazine 250 mg/m² — 5 courses given every 4 weeks. Because of a good tumor response was observed 3D megavoltage radiation therapy (RT) was administered to the tumor bed in total dose of 52.8 Gy in 20 fractions given 3 times a week. Complete remission of the tumor was achieved. Currently, after 6 years, there is no evidence of active disease. The quality of life of the patient remains satisfactory. Despite the advanced clinical stage of melanoma at presentation, sequential chemoradiotherapy was an effective treatment for the mucosal melanoma patient.