What are head and neck mucosal melanomas?

Updated: May 07, 2020
  • Author: Neeraj N Mathur, MBBS, MS, DNB(ENT), MNAMS, FAMS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

Mucosal melanoma of the head and neck is a relatively rare condition, representing 8-15% of all malignant melanomas of the head and neck region and accounting for less than 1% of all melanomas. Mucosal melanomas show far more aggressive behavior relative to skin melanomas, and these tumors are more inclined to metastasize into regional and distant sites or recur locally, regionally, or in distant locations, resulting in a high rate of cause-specific death. The prognosis is grim, with most published reports documenting a dismal 5-year survival rate of 10-15%.

A retrospective study by Bakkal et al of 10 patients with mucosal melanoma of the head and neck region found 3-year disease-free and overall survival rates to be 11.7% and 35%, respectively, while the 5-year rates were 11.7% and 23.3% respectively. Median disease-free and overall survival periods of 12 and 17 months, respectively, were also reported. The study also found local, regional, and systemic recurrence rates of 20%, 50%, and 80%, respectively, with lung involvement having occurred in all patients with distant metastases. [1]

A study by Meerwein et al of patients with sinonasal mucosal melanoma found that of those treated with curative intent, the 1- and 3-year overall survival rates were 60% and 40%, respectively. Patients who additionally underwent immunotherapy had a median progression-free survival (PFS) period of 5 months, although the overall survival rate did not differ between patients who were treated with immunotherapy and those who were not. [2]

Because of its rarity, mucosal melanoma is poorly understood, characterized, and studied. Mucosal melanomas in the head and neck region account for half of all mucosal melanomas, occurring mainly in the upper respiratory tract, oral cavity, and pharynx. Besides the head and neck region, mucosal melanomas arise from the mucosal membranes of the female genital organs or the anorectal and urinary tracts.

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