How are head and neck mucosal melanomas treated?

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

The treatment of choice for mucosal melanoma, like cutaneous melanoma, is complete excision with adequate negative margins. In consequence of presence of surrounding vital structures, positive surgical margins are common.

Controversies in treatment of head neck melanomas include lymphoscintigraphy with sentinel node biopsy, nodal dissection, margin size, role of radiation therapy, and reconstruction. Unfortunately, mucosal melanoma tends to spread radially and involve large areas of mucosa.

Therapeutic neck dissection is indicated for lymph node metastasis in the neck. Elective lymph node dissection in local disease only is not recommended because of the low frequency of subsequent development of lymph node metastasis. The issue of sentinel node biopsy, which is achieving growing acceptance in the treatment of cutaneous malignant melanoma, has not been studied in mucosal melanoma.


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