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Electrochemotherapy as adjuvant treatment in a sinonasal mucosal melanoma in elderly patient: a case report

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Abstract

Background

Sinonasal Mucosal Melanoma (SNMM) is a rare but aggressive disease. Surgery with free margins, when feasible, is the treatment of choice. In the last three decades, electrochemotherapy (ECT) has emerged as a local ablative procedure, performed with the Cliniporator, for cutaneous and mucosal tumours of different histology. We present a case report of an ECT treatment performed by means of a new endoscopic electrode, on an elderly patient affected by primary SNMM.

Methods

An 88-year-old man with a diagnosis of SNMM (cT4aN0M0)—Stage IV, of the left nasal fossa presented at our institution. Symptoms were epistaxis and complete left nasal obstruction. He refused sinonasal extended surgery and radiotherapy. He underwent a tumor debulking followed by ECT exclusively for symptom control, with palliative intent.

Results

The patient underwent SNMM debulking under general anaesthesia, followed by ECT on tumour margins. After the procedure, he had been free from symptoms for 5 months, with a good quality of life. Local recurrence was controlled with a new local debulking and ECT procedure on margins. The patient remained symptom free for the next 4 months. Seventeen months after diagnosis, the patient is mild symptomatic for sinonasal disease. Therefore, he developed a systemic disease progression.

Conclusions

In our experience, ECT can be used as an adjuvant tool for symptom and local control in SNMM when extended surgery is out of curative intent or unfeasible. As expected, ECT does not appear to have any effect on systemic disease progression.

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Data availability

The data of the study are available upon request.

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Acknowledgements

We would like to thank all nurses, operating room and oncology staff of the Azienda Unità Locale Socio-Sanitaria (AULSS 3) Serenissima, Mirano Hospital, Venice, Italy.

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Authors and Affiliations

  1. Otolaryngology Unit, Azienda Unità Sanitaria Locale Socio Sanitaria (AULSS) 3 Serenissima - Ospedale di Mirano, Venice, Italy

    Silvia Carpenè, Martina Bertinazzi, Enrico Armato & Maurizio Amadori

  2. Oncology and Haematology Unit, Azienda Unità Sanitaria Locale Socio Sanitaria (AULSS) 3 Serenissima - Ospedale di Mirano, Venice, Italy

    Barbara Silvestri & Giuseppe Azzarello

  3. Otolaryngology Unit, Azienda Unità Sanitaria Locale Socio Sanitaria (AULSS) 3 Serenissima - Ospedale di Mestre, Venice, Italy

    Roberto Spinato

  4. IGEA Biophysics Lab. Carpi, Modena, Italy

    Francesca de Terlizzi

Authors
  1. Silvia Carpenè
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  2. Barbara Silvestri
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  3. Martina Bertinazzi
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Contributions

Patient’s treatment and data collection: SC and BS. Discussion of the case report: SC, BS, MB, EA, MA, RS, GA. Data reporting and manuscript preparation: SC, BS, FdT. Manuscript revision: SC, BS, MB, EA, MA, RS, GA.

Corresponding author

Correspondence to Barbara Silvestri.

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Declarations

The authors did not receive support from any organization for the submitted work. Francesca de Terlizzi is an IGEA employer.

Conflict of interest

The only conflict of interest can be ascribed to the fact that the author FdT is an IGEA employer.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The participant has consented to the submission of the case report to the journal.

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Carpenè, S., Silvestri, B., Bertinazzi, M. et al. Electrochemotherapy as adjuvant treatment in a sinonasal mucosal melanoma in elderly patient: a case report. Eur Arch Otorhinolaryngol (2024). https://doi.org/10.1007/s00405-024-08606-z

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