A rare case of isolated melanoma of the sphenoid sinus

<b>Introduction:</b> Sphenoid sinus melanoma is extremely rare – only 7 cases have been described in the available literature.<b>Aim:</b> We present the next case of a 77-year-old female with melanoma of the left sphenoid sinus treated in our ENT Department.<b>Case study:</b> A 77-year-old female was admitted to our department due to the histologically confirmed left sphenoid sinus malignant melanoma. During admission, the patient was treated with Pembrolizumab at the Oncology Center in Gliwice. In our department, she underwent endoscopic surgery of the left sphenoid sinus and nasopharynx six times. The patient’s last admission on 04/2023 was caused by the heavy epistaxis from the left nasal cavity. She died less than a year after the last surgical intervention (04/2023) due to the generalization of the neoplastic disease.<b>Conclusions:</b> Malignant melanoma of the sphenoid sinus is an extremely rare neoplasm. The endoscopic resection of the tumor remains the treatment of choice. However, newer modalities like biologic and immunomodulatory treatments are being studied. The 5-year survival rates in these cases are only 10–15%.