Malignant Amelanotic Melanoma of the Middle Ear

We report the first case (to our knowledge) of malignant melanoma of amelanotic type arising from the mucosa of the middle ear. An 81-year-old man who presented with right hearing loss was diagnosed as having otitis media with effusion at an otolarygology clinic. Despite subsequent treatment, he developed otorrhea and otalgia. Furthermore, a granular mass was found in the pars flaccida of the tympanic membrane. A biopsy of the mass was performed, and the findings were suggestive of malignant melanoma. The disease was already in an advanced stage, because metastases were noted in the patient's lungs and liver. Although chemohormonal therapy was performed and was slightly effective in reducing the primary tumor, the patient died of acute renal failure. Autopsy confirmed the diagnosis of amelanotic melanoma of the middle ear.