Primary melanoma of the sphenoid sinus

The head and neck area accounts for approximately 20% of all (cutaneous and mucosal) melanomas. However, only 1% arise in the sinonasal tract.1 The most commonly affected sites, in descending order, are the nasal cavity, maxillary sinus, ethmoid sinus, and frontal sinus. Primary melanoma of the sphenoid sinus is extremely rare. In a review of 194 reported cases of sinonasal melanoma by Batsakis et al,1 none originated in the sphenoid sinus.