PMC4755470_01
Preoperative CT scan showing the nasal tumor.. Notes: (A) Axial computed tomography scan of sinus with a parenchymal opening; (B) coronal bone with an opening showing a thickening tissue of the right nasal cavity.
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The computed tomography scan found thickening tissue of the right nasal cavity remaining confined without any suspicious abnormality (Figure 1).
Infiltration of the right nasal cavity wall with a melanoma arriving in depth to the cartilage without invading it.. Notes: Hematoxylin-eosin-saffron staining (magnification x 2). Image courtesy of JL Kemeny.. Abbreviation: hematoxylin-eosin-saffron.
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The biopsy performed under local anesthesia with a histopathological analysis of the sample reported a malignant melanoma globocellular type of nasal septum (Figure 2).
Detail of tumor melanoma cells that have an atypical nucleus. Note: Image courtesy of JL Kemeny.
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The lesion was strongly expressing vimentin and human melanoma black 45 (HBM45) (Figure 3).
Brown marking of intracytoplasmic tumor cells with HMB45 and melan A in immunohistochemistry on paraffin section (magnification x40).. Note: Image courtesy of JL Kemeny.
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The anatomopathological analysis of surgical specimens confirmed the malignant melanoma (1.5 cm-long axis, infiltration and ulceration of the right nasal cavity, globular cells of an epitheloid appearance rich in cytonuclear irregularity, large nucleus with nucleolus strongly thickened with nuclear membrane and a coarse chromatin with mitosis), which came into contact with the overlap of the lower septum (Figure 4).
Postoperative computed tomography showing empty nasal cavities.
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Clinical (ENT, ophthalmology, medical) and radiological (computed tomography, chest X-ray, ultrasound) examinations performed every 3 months were unremarkable (Figure 5).