Melanotic Oncocytic Metaplasia of the Nasopharynx: A Benign Mimic of Mucosal Melanoma.

A 61-year-old man was found to have incidental multifocal, pigmented nasopharyngeal lesions during the evaluation of an unrelated thyroid nodule. The progressive appearance of multiple hyperpigmented macules on the torus tubarius raised concern for mucosal melanoma, an aggressive malignancy. Histopathologic examination ultimately established the diagnosis of melanotic oncocytic metaplasia, a benign lesion of the nasopharynx. Recognition of this entity is important because it may clinically and endoscopically mimic melanoma, yet it follows a benign course and requires only conservative management.