Article
A Case of Eustachian Tube Melanoma
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Published: | April 14, 2014 |
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Introduction: Mucosal melanoma of the Eustachian tube is extremely rare. Here, we share our experience in the management of a 55-year-old Chinese lady with right Eustachian tube melanoma. She presented with right-sided hearing loss of 2 months duration. Otoscopy revealed a right serous otitis media. Nasoendoscopy revealed a blackish mass at the right Eustachian tube opening. A biopsy of this mass was done and histology revealed malignant melanoma.
We discuss our surgical approach in the excision of Eustachian tube melanoma. Our case report also compares all other cases of Eustachian tube melanoma that has been reported in the literature so far.
Method: We combine both a Fisch Type B infratemporal approach and maxillary swing in the excision of the Eustachian tube melanoma.
Results: Our patient's post-operative recovery was good, with only a small dehiscence of the palatal flap. Her final histology showed that all resection margins were clear. She underwent 30 sessions of adjuvant radiotherapy.
Conclusion: Melanoma of the Eustachian tube is a rare condition, with only 8 other cases being reported in the literature so far. Majority of patients present with localised disease, without nodal metastases, as otitis media with effusion. Surgery is the main treatment for patients with mucosal melanoma of the Eustachian tube. However, excision of mucosal melanoma of the Eustachian tube is challenging due to its deep-seated nature from the nasopharynx to the middle ear, and close proximity to critical structures such as the internal carotid artery and facial nerve. The role of adjuvant radiotherapy remains undetermined.
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