Update on Primary Head and Neck Mucosal Melanoma

Head Neck. 2016 Jan;38(1):147-55. doi: 10.1002/hed.23872. Epub 2015 May 22.

Abstract

Primary mucosal melanomas (PMMs) of the head and neck are uncommon malignancies that arise mainly in the nasal cavity and paranasal sinuses, followed by the oral cavity. The mainstay of treatment is radical surgical resection followed by adjuvant radiotherapy in selected patients with high-risk features. Multimodality therapy has not been well studied and is not standardized. Adjuvant radiotherapy seems to improve locoregional control but does not improve overall survival (OS). Elective neck dissection is advocated in patients with oral PMM. Systemic therapy should be considered only for patients with metastatic or unresectable locoregional disease. Despite improvements in the field of surgery, radiotherapy, and systemic therapy, patients with PMM still face a very unfavorable prognosis (5-year disease-free survival [DFS] <20%) with high rates of locoregional recurrence and distant metastasis. The present review aims to summarize the current state of knowledge on the molecular biology, pathological diagnosis, and management of this disease.

Keywords: chemotherapy; diagnosis; head and neck; mucosal melanoma; outcomes; radiotherapy; staging system; surgery.

Publication types

  • Review

MeSH terms

  • Combined Modality Therapy
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Melanoma / mortality
  • Melanoma / pathology
  • Melanoma / therapy*
  • Mouth Neoplasms / therapy
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm Staging
  • Nose Neoplasms / therapy
  • Paranasal Sinus Neoplasms / therapy
  • Prognosis
  • Risk Factors
  • Treatment Outcome