Skip to main content

Advertisement

SpringerLink
Log in

Malignant mucosal melanoma of the head and neck — a review

  • Review
  • Published:
Pathology Oncology Research

Abstract

Mucosal melanomas comprise about 1% of all malignant melanomas and exhibit far more aggressive behaviour than that of skin melanomas: they are more inclined to metastatize into regional and distant sites or recur locally, regionally or in distant locations, resulting in a high rate of cause-specific death. 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. They appear with equal gender distribution and with a peak incidence in the age range 60–80 years. In consequence of their hidden location, they are usually diagnosed in a locoregionally advanced clinical stage, with a rate of 5–48% of regional and 4–14% of distant dissemination. The typical therapeutic approach is surgery, postoperative irradiation and systemic therapy. Local control with either surgery or radiotherapy is frequently (60–70%) achieved, but the rates of local, regional and distant recurrences are high (50–90%, 20–60% and 30–70%, respectively). The reported 5-year actual survival rates are poor (17–48%), which is attributed mainly to a haematogenous dissemination. These characteristics demonstrate that identification of the precursor lesions and more effective local and systemic approaches are needed to improve the therapeutic results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Agarwala SS, Atkins MB, Kirkwood JM: Current approaches to advanced and high-risk melanoma. Proc Am Soc Clin Oncol 2000.

  2. Ang KK, Byers RM, Peters LJ, et al: Regional radiotherapy as adjuvant treatment for head and neck malignant melanoma. Arch Otolaryngol Head Neck Surg 116:169–172, 1990.

    PubMed  CAS  Google Scholar 

  3. Bánfalvi T, Boldizsár M, Gergye M, et al: Comparison of prognostic significance of serum 5-S-Cysteinyldopa, LDH and S-100B protein in Stage III-IV malignant melanoma. Pathol Oncol Res 8:183–187, 2002.

    Article  PubMed  Google Scholar 

  4. Barranco SC, Romsdahl MM, Humphrey RM: The radiation response of human malignant melanoma cells grown in vitro. Cancer Res 31:830–831, 1971.

    PubMed  CAS  Google Scholar 

  5. Barton RT: Mucosal melanomas of the head and neck. Laryngoscope 85:93–99, 1975.

    Article  PubMed  CAS  Google Scholar 

  6. Batsakis JD, Regezi JA, Solomon AR, et al: The pathology of head and neck tumors-part 13: mucosal melanomas. Head Neck Surg 4:404–412, 1982.

    Article  PubMed  CAS  Google Scholar 

  7. Berking C, Schlüpen E, Schrader A, et al: Tumor markers in peripheral blood of patients with malignant melanoma: Multimarker RT-PCR versus a luminometric assay for S-100. Arch Dermatol Res 291:479–484, 1999.

    Article  PubMed  CAS  Google Scholar 

  8. Blatchford SJ, Koopman CF, Coulthard SW: Mucosal melanoma of the head and neck. Laryngoscope 96:929–934, 1986.

    Article  PubMed  CAS  Google Scholar 

  9. Brandwein MS, Rothstein A, Lawson W, et al: A clinicopathologic study of 25 cases and literature meta-analysis. Arch Otolaryngol Head Neck Surg 123:290–296, 1997.

    PubMed  CAS  Google Scholar 

  10. Britten CD, Rowinsky EK, Baker SD, et al: A phase I and pharmacokinetic study of temozolomide and cisplatin in patients with advanced solid malignancies. Clin Cancer Res 5:1629, 1999.

    PubMed  CAS  Google Scholar 

  11. Chang AE, Karnell LH, Menck HR: The National Cancer Data Base Report on cutaneous and noncutaneous melanoma. Cancer 83:1664–1678, 1998.

    Article  PubMed  CAS  Google Scholar 

  12. Chapman PB, Einhorn LH, Meyers ML, et al: Phase III multicenter randomized trial of the Dartmouth regimen versus dacarbazine in patients with metastatic melanoma. J Clin Oncol 17:2745, 1999.

    PubMed  CAS  Google Scholar 

  13. Chaundhry AP, Hampel A, Gorlin RJ: Primary melanoma of the oral cavity. Cancer 11:923–928, 1958.

    Article  Google Scholar 

  14. Cocconi G, Bella M, Calabresi F, et al: Treatment of metastatic malignant melanoma with dacarbazine plus tamoxifen. N Engl J Med 327:516, 1992.

    PubMed  CAS  Google Scholar 

  15. Eneroth CM, Lungberg C: Mucosal malignant melanomas of the head and neck. Acta Otolaryngol 80:452–458, 1975.

    Article  PubMed  CAS  Google Scholar 

  16. Falkson CI, Falkson G, Falkson HC: Improved results with the addition of interferon alfa-2b to dacarbazine in the treatment of patients with metastatic malignant melanoma. J Clin Oncol 9:1403, 1991.

    PubMed  CAS  Google Scholar 

  17. Falkson CI, Ibrahim J, Kirkwood JM, et al: Phase III trial of dacarbazine versus dacarbazine with interferon -2b versus dacarbazine with interferon -2b and tamoxifen in patients with metastatic malignant melanoma: an Eastern Cooperative Oncology Group study (E3690). J Clin Oncol 16:1743, 1998.

    PubMed  CAS  Google Scholar 

  18. Freedman HM, De Santo LW, Devine KD, et al: Malignant melanoma of the nasal cavity and paranasal sinuses. Arch Otolaryngol 97: 322–325, 1973.

    PubMed  CAS  Google Scholar 

  19. Gilligan D, Slevin NJ: Radical radiotherapy for 28 cases of mucosal melanoma in the nasal cavity and sinuses. Br J Radiol 64:1147–1150, 1991.

    PubMed  CAS  Google Scholar 

  20. Greco FA, Hainsworth JD: Cancer of unknown primery site. In: Cancer: principles and practice of oncology (Eds.: de Vita VT Jr, Hellman S, Rosenberg SA) 6th ed, Lippincott Williams and Wilkins, Philadelphia-Baltimore-New York-London-Buenos Aires-Hong Kong-Sydney-Tokyo, 2001, pp. 2537–2569.

    Google Scholar 

  21. Goldman JA, Lawson W, Zak FG, et al: The presence of melanocytes in human larynx. Laryngoscope 82:824–835, 1972

    Article  PubMed  CAS  Google Scholar 

  22. Gotshalk HC, Tessmer CF, Smith JW Malignant melanoma of palate. Arch Pathol 30:762, 1940.

    Google Scholar 

  23. Guzzo M, Grandi C, Licitra L, et al: Mucosal malignant melanoma of head and neck: forty-eight cases treated at Instituto Nazionale Tumori of Milan. Eur J Surg Oncol 19:316–319, 1993.

    PubMed  CAS  Google Scholar 

  24. Hall EJ. Radiobiology for the radiologists. 5th ed. Philadelphia: Lippincott-Williams and Wilkins, 2000.

    Google Scholar 

  25. Harrison DFN, Lund VJ: Tumors of the upper jaw. Edinburgh, London: Churchill Livingstone, 1993, pp. 332.

    Google Scholar 

  26. Keilholz U, Eggermont AM: The role of interleukin-2 in the management of stage IV melanoma: the EORTC melanoma cooperative group program. Canc J Scient Am 6:S99, 2000.

    Google Scholar 

  27. Kingdom TT, Kaplan MJ: Mucosal melanoma of the nasal cavity and paranasal sinuses. Head Neck 17:184–189, 1995.

    Article  PubMed  CAS  Google Scholar 

  28. Lange JR, Raubitschek AA, Pockaj BA, et al: A pilot study of the combination of interleukin-2-based immunotherapy and radiation therapy. J Immunother 12:265, 1992.

    Article  PubMed  CAS  Google Scholar 

  29. Lattanzi SC, Tosteson T, Chertoff J, et al: Dacarbazine, cisplatin and carmustine, with or without tamoxifen, for metastatic melanoma: 5-year follow up. Melanoma Res 5:365, 1995.

    Article  PubMed  CAS  Google Scholar 

  30. Lee SP, Shimizu KT, Tran LM, et al: Mucosal melanoma of the head and neck: the impact of local control on survival. Laryngoscope 104:121–126, 1994.

    PubMed  CAS  Google Scholar 

  31. Legha SS, Ring S, Eton O, et al: Development of a biochemotherapy regimen with concurrent administration of cisplatin, vinblastine, dacarbazine, interferon alfa and interleukin-2 for patients with metastatic melanoma. J Clin Oncol 16:1752, 1998.

    PubMed  CAS  Google Scholar 

  32. Liversedge RL: Oral malignant melanoma. Br J Oral Surg 13:40–55, 1975.

    Article  PubMed  CAS  Google Scholar 

  33. Lotze MT, Dallal RM, Kirkwood JM, et al: Cutaneous melanoma. In: Cancer: principles and practice of oncology (Eds.: de Vita VT Jr, Hellman S, Rosenberg, SA) 6th ed, Lippincott Williams and Wilkins, Philadelphia-Baltimore-New York-London-Buenos Aires-Hong Kong-Sydney-Tokyo, 2001, 2012–2069.

    Google Scholar 

  34. Lund VJ: Malignant melanoma of the nasal cavity and paranasal sinuses. J Laryngol Otol 96:347–355, 1982.

    PubMed  CAS  Google Scholar 

  35. Lund VJ: Malignant melanoma of the nasal cavity and paranasal sinuses. ENT J 72:285–290, 1993.

    CAS  Google Scholar 

  36. Lund VJ, Howard DJ, Harding L, et al: Management options and survival in malignant melanoma of the sinonasal mucosa. Laryngoscope 109:208–211, 1999.

    Article  PubMed  CAS  Google Scholar 

  37. Middleton MR, Grob JJ, Aaronson N, et al: Randomized phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma. J Clin Oncol 18:158, 2000.

    PubMed  CAS  Google Scholar 

  38. Pandey M, Mathew A, Iype EM, et al: Primary malignant mucosal melanoma of the head and neck region: pooled analysis of 60 published cases from India and review of literature. Eur J Cancer Prevention 11:3–10, 2002.

    Article  CAS  Google Scholar 

  39. Patel SG, Prasad ML, Escrig M, et al: Primary mucosal malignant melanoma of the head and neck. Head Neck 24:247–257, 2002.

    Article  PubMed  Google Scholar 

  40. Perez CA, Chao KSC. Mucosal Melanoma. In Principle and Practice of Radiation Oncology. (Eds.: Perez CA, Brady LW.) 3rd ed, Philadelphia-New York: Lippincott-Raven, 1997, pp. 1122–1123.

    Google Scholar 

  41. Rinaldo A, Shaha AR, Patel SG, et al: Primary mucosal melanoma of the nasal cavity and paranasal sinuses. Acta Otolaryngol 121:979–982, 2001.

    Article  PubMed  CAS  Google Scholar 

  42. Rosenberg Sa, Yanelli Jr, Yang JC, et al: Treatment of patients with metastatic melanoma with autologous tumor-infiltrating lymphocytes and interleukin-2. J Natl Cancer Inst 86:1159, 1994.

    Article  PubMed  CAS  Google Scholar 

  43. Rosenberg SA, White DE: Vitiligo in patients with melanoma: normal tissue antigens can be targets for cancer immuntherapy. Journal of Immuntherapy with Emphasis on Tumor Immunology 19:81, 1996.

    CAS  Google Scholar 

  44. Rosenberg Sa, Yang JC, Schwartzentruber DJ, et al: Prospective randomized trial of the treatment of patients with metastatic melanoma using chemotherapy with cisplatin, dacarbazine, and tamoxifen alone or in combination with interleukin-2 and interferon alfa-2b. J Clin Oncol 17:968, 1999.

    PubMed  CAS  Google Scholar 

  45. Shah JP, Huvos AG, Strog EW: Mucosal melanomas of the head and neck. Am J Surg 134:531–535, 1977.

    Article  PubMed  CAS  Google Scholar 

  46. Shibuya H, Takeda M, Matsumoto S, et al: The efficacy of radiation therapy for malignant melanoma in the mucosa of the upper jaw: an analytic study. Int J Radiat Oncol Biol Phys 25:35–39, 1992.

    Google Scholar 

  47. Stern SJ, Guillamondegui OM: Mucosal melanoma of the head and neck. Head Neck 13:22–27, 1991.

    Article  PubMed  CAS  Google Scholar 

  48. Tagliaferri P, Barile C, Caraglia M, et al: Daily low-dose subcutaneous recombinant interleukin-2 by alternate weekly administration: antitumor activity and immunomodulatory effects. Am J Clin Oncol 21:48, 1998.

    Article  PubMed  CAS  Google Scholar 

  49. Takagi M, Ishikawa G, Mori W: Primary malignant melanoma of the oral cavity in Japan. Cancer 34:358, 1974.

    Article  PubMed  CAS  Google Scholar 

  50. Timár J, Csuka O, Orosz Z, et al: Molecular pathology of tumor metastasis. I. Predictive pathology. Pathol Oncol Res 7:217–230, 2001.

    Article  PubMed  Google Scholar 

  51. Trapp TK, Fu Y-S, Calcaterra TC: Melanoma of the nasal and paranasal sinus mucosa. Arch Otolaryngol Head Neck Surg 113:1086–1089, 1987.

    PubMed  CAS  Google Scholar 

  52. Trott KR, von Lieven H, Kummermehr J, Skopal D, et al: The radiosensitivity of malignant melanomas. Part I: Experimental studies. Int J Radiat Oncol Biol Phys 7:9–13, 1981.

    PubMed  CAS  Google Scholar 

  53. Trott KR, von Lieven H, Kummermehr J, et al. Radiosensitivity of malignant melanomas. Part II: Clinical studies. Int J Radiat Oncol Biol Phys 7:15–20, 1981.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiotherapy, National Institute of Oncology, Budapest, Ráth Gy. u. 7-9, 1122, Budapest, Hungary

    Erzsébet Lengyel & Olga Ésik

  2. Department of Dermatology, National Institute of Oncology, Budapest, Hungary

    Katalin Gilde

  3. Department of Head and Neck Surgery, National Institute of Oncology, Budapest, Hungary

    Éva Remenár

  4. Department of Oncotherapy, Section of Radiotherapy, Semmelweis University, Budapest

    Olga Ésik

Authors
  1. Erzsébet Lengyel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katalin Gilde
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Éva Remenár
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Olga Ésik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Erzsébet Lengyel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lengyel, E., Gilde, K., Remenár, É. et al. Malignant mucosal melanoma of the head and neck — a review. Pathol. Oncol. Res. 9, 7–12 (2003). https://doi.org/10.1007/BF03033707

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03033707

Keywords

Search

Navigation