Overview
Sinonasal melanoma is a rare cancer that arises from pigment-producing cells in the lining (mucosa) of the nose and sinuses. It is a form of mucosal melanoma and behaves differently from the more familiar melanoma of the skin, including in its causes, staging, and treatment.
Because it develops inside the nose, sinonasal melanoma often causes one-sided nasal blockage and nosebleeds, and it may not be visible from the outside. Diagnosis requires endoscopic examination, imaging, and a biopsy with expert pathology review.
Care is multidisciplinary and individualized. Treatment commonly centers on surgery with careful attention to margins, often combined with radiation, and may include immunotherapy or other systemic treatment. Because recurrence is a concern, long-term surveillance is important. This page is educational and does not replace specialist evaluation.
How mucosal melanoma differs from skin melanoma
Sinonasal melanoma is a mucosal melanoma, arising from pigment cells in the lining of the nose and sinuses rather than from the skin. Unlike skin melanoma, it is not linked to sun exposure, it is often diagnosed at a more advanced stage because it is hidden inside the nose, and it is staged and treated differently.
One-sided obstruction and bleeding
Because it grows inside the nose, sinonasal melanoma commonly causes one-sided nasal blockage and recurrent nosebleeds. Some tumors are darkly pigmented while others are not, so appearance alone does not rule it out. Persistent one-sided nasal symptoms should be evaluated.
Living with sinonasal melanoma? The next step is a quiet, unhurried conversation.
Biopsy, imaging, and staging
Diagnosis involves nasal endoscopy, a biopsy with expert pathology review, and imaging with CT and MRI to define the tumor's extent. Additional imaging is used for staging to assess whether the cancer has spread. Accurate pathology is important because melanoma can resemble other tumors.
Surgery and margin planning
Surgery to remove the tumor is the cornerstone of treatment for many patients, with careful planning to achieve clear margins while protecting nearby structures such as the eye and skull base. Depending on the tumor, surgery may be endoscopic, open, or a combination.
Radiation and immunotherapy or systemic therapy
Radiation therapy is frequently added after surgery to improve local control. Immunotherapy and other systemic treatments play an increasing role, particularly for more advanced or spread disease, and are coordinated with medical oncology. The plan is individualized.
Living with sinonasal melanoma? The next step is a quiet, unhurried conversation.
Recurrence and surveillance
Sinonasal melanoma can recur locally or spread elsewhere, so long-term surveillance with examination and imaging is an essential part of care. Ongoing follow-up allows recurrence to be identified and addressed as early as possible.
When to seek care
Seek prompt evaluation for persistent one-sided nasal blockage, recurrent nosebleeds, or a new mass in the nose. Seek emergency care for heavy nosebleeds that do not stop with firm pressure, which require immediate attention.
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Living with sinonasal melanoma? The next step is a quiet, unhurried conversation.
Common Symptoms
Treatment Approach
Treatment for sinonasal melanoma is individualized based on the severity of symptoms, anatomical considerations, and patient goals. Our specialists may consider:
- 01Surgery with attention to margins
- 02Radiation therapy in many cases
- 03Immunotherapy or other systemic therapy in selected cases
- 04Coordinated, multidisciplinary planning
- 05Long-term surveillance for recurrence
Specialists who treat sinonasal melanoma
Dr. Adrian Ong
MD
Board-Certified Facial Plastic & Reconstructive and Head & Neck Surgeon
Dr. Adrian Ong is a board-certified surgeon who practices exclusively on the face, head, and neck, with expertise spanning rhinoplasty, sinus surgery, facial trauma, reconstruction, and sleep surgery.
- Functional and aesthetic rhinoplasty (including revision)
- Sinus surgery and complex revision sinus surgery
- Facial trauma and nasal fractures
- Head and neck cancer surgery and microvascular reconstruction
Also caring for this area
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Clinical References
These independent resources from medical and professional organizations offer further reading. They are provided for general education and do not replace a consultation with a clinician.
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