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Head and neck mucosal melanoma: radiological considerations and UK imaging guidelines

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Abstract

Purpose

Awareness of head and neck mucosal melanoma (HNMM) is important, as incorrect work-up can impact on the investigation and management of this rare and aggressive cancer. Following on from the 2020 HNMM UK guidelines, we set out the imaging recommendations and their rationale. To illustrate the key imaging characteristics, we also include a case series from our centre.

Methods

All HNMM cases managed at our institution from January 2016 to January 2021 were identified, and the available imaging for each patient was reviewed. For each patient, the age, gender and location of primary tumour was recorded together with key staging and diagnostic imaging parameters.

Results

A total of 14 patients were identified. The median age was 65 years with a female to male ratio of 1.33:1. Primary tumours were sinonasal in location in 93% of cases, with 7% of patients having metastatic neck nodes at presentation and 21% of cases having distant metastatic disease at presentation.

Conclusion

This data set is in general concordance with other published series regarding the sinonasal origin of the vast majority of HNMM tumours along with the proportion of patients with metastatic neck nodes and distant metastases at presentation. We recommend dual-modality imaging with computed tomography (CT) and magnetic resonance imaging (MRI) of primary tumours whenever possible. In the systematic staging of HNMM, positron emission tomography (PET)-CT should be strongly considered, together with MRI of the brain. Pre-biopsy imaging of HNMM tumours is advisable whenever possible.

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Data availability

The data sets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Radiology, Royal Marsden Hospital, London, UK

    Ashwin Algudkar & Derfel ap Dafydd

  2. Department of Medical Oncology, Royal Marsden Hospital, London, UK

    Kevin Harrington

  3. The Institute of Cancer Research, London, UK

    Kevin Harrington

  4. Department of Head & Neck Surgery, Royal Marsden Hospital, London, UK

    Cyrus Kerawala

  5. Department of Histopathology, Royal Surrey Hospital, Guildford, UK

    Izhar Bagwan

Authors
  1. Ashwin Algudkar
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  2. Kevin Harrington
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  3. Cyrus Kerawala
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  4. Izhar Bagwan
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  5. Derfel ap Dafydd
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Contributions

The article and observational study format was designed by DaD; data collection and analysis were performed by AA; the primary author of the manuscript was AA; the secondary author of the manuscript was DaD; AA, KH, CK, IB and DaD were all involved in the editing, review and preparation of the final article.

Corresponding author

Correspondence to Derfel ap Dafydd.

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Ethics approval and consent to participate

Ethical approval was not required as this was a retrospective observational case series analysis and hence consent to participate was also not required. Research and development service evaluation approval was obtained from the Royal Marsden Hospital, London, UK.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Algudkar, A., Harrington, K., Kerawala, C. et al. Head and neck mucosal melanoma: radiological considerations and UK imaging guidelines. Oral Maxillofac Surg 28, 363–372 (2024). https://doi.org/10.1007/s10006-023-01150-w

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  • DOI: https://doi.org/10.1007/s10006-023-01150-w

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