Morphological and Immunohistochemical Aspects with Prognostic Implications and Therapeutic Targets of Primary Sinonasal Mucosal Melanoma: A Retrospective Study

Author:

Trandafir Cornelia Marina1,Closca Raluca Maria23ORCID,Poenaru Marioara14,Sarau Oana Silvana56,Sarau Cristian Andrei67ORCID,Rakitovan Marina38,Baderca Flavia23ORCID,Sima Laurentiu Vasile910ORCID

Affiliation:

1. ENT Department, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania

2. Department of Pathology, Emergency City Hospital, 300254 Timisoara, Romania

3. Department of Microscopic Morphology, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania

4. ENT Department, Emergency City Hospital, 300254 Timisoara, Romania

5. Hematology Department of the Municipal Emergency Clinical Hospital, 300254 Timisoara, Romania

6. Faculty of Medicine, University of Medicine and Pharmacy “Victor Babes”, 300041 Timisoara, Romania

7. Internal Medicine Department of the Municipal Emergency Clinical Hospital, 300254 Timisoara, Romania

8. Oro-Maxillo-Facial Surgery Clinic of the Emergency City Hospital, 300062 Timisoara, Romania

9. Department of Surgery, University of Medicine and Pharmacy “Victor Babes”, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania

10. Department of Surgery, Emergency City Hospital, Gheorghe Dima Square No 5, 300254 Timisoara, Romania

Abstract

Sinonasal mucosal melanoma originates from melanocytes and it is a rare malignancy in the sinonasal tract. It is an aggressive melanocytic neoplasm with a very poor prognosis. The symptoms are nonspecific and the diagnosis is delayed, usually until the advanced stages of the disease. The current study performs a correlation between the histopathological aspects of sinonasal mucosal melanoma and different types of immune cells present in the microenvironment, with prognostic and therapeutic implications. The endpoint is to quantify the cellular immune microenvironment and correlate it with patient survival. This study presents nine cases of primary sinonasal mucosal melanomas diagnosed at the Emergency City Hospital Timisoara, Romania during a period of 15 years. The histopathological examination was performed in the Department of Pathology of the same hospital, using morphological hematoxylin–eosin staining. Additional immunohistochemical reactions were performed to confirm the diagnosis and evaluate the components of the tumor immune microenvironment. This study identifies eosinophils, macrophages, natural killer cells and plasma cells as favorable prognostic factors. Therefore, a CD8:CD4 ratio of more than 3 is correlated with a good response to PD-1 inhibitor therapy.

Publisher

MDPI AG

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