Sinonasal amelanotic malignant melanoma – A diagnostic dilemma

Malignant melanoma involving mucosal surface of the head and neck region is rare. Malignant melanoma involving the nasal cavity is even rarer and accounts for less than 1% of cases. Prognosis is generally poor with unpredictable outcome. Regional and distant metastasis is common at presentation. We present a case of a 60 year old female who presented with polypoidal mass in the left nasal cavity and occasional history of nasal bleed. Endoscopic excision of the mass was done with a clinical diagnosis of inverted papilloma. Microscopic examination of the lesion was suggestive of amelanotic malignant melanoma and was confirmed by immunohistochemistry. She subsequently received chemotherapy and radiotherapy.