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Case History

A 58-year-old male presents with nasal obstruction. An exam shows a polypoid mass arising from the anterior nasal septum. Sections show a spindled to epithelioid neoplasm underlying nasal epithelium. Provided are the H&E and SOX10 IHC. 

What genetic alteration is most commonly found in this entity at this location?

  1.        BRAF
  2.        NRAS
  3.        KIT
  4. NF1
  5. BAP1

Prater Case 2022 1 Prater Case 2022 2   

This is a case of sinonasal melanoma. While BRAF is the most common genetic alteration in cutaneous melanoma (52%), according to the WHO Classification of Tumors of the Head and Neck 5th edition, KIT is the most commonly detected genetic alteration in mucosal melanoma of the sinonasal tract (15%), followed by NRAS (12%) and NF1 (10%). 


  1. 1. WHO Classification of Tumours Editorial Board. Head and neck tumours. Lyon (France): International Agency for Research on Cancer; forthcoming. (WHO classification of tumours series, 5th ed.; vol. 9). https://publications.iarc.fr.
  2. Nassar KW, Tan AC. The mutational landscape of mucosal melanoma. Semin Cancer Biol. 2020 Apr;61:139-148. doi: 10.1016/j.semcancer.2019.09.013. Epub 2019 Oct 23. PMID: 31655118; PMCID: PMC7078020.


Case contributed by: Anne Prater, D.O.Surgical Pathology Fellow, UAB Pathology