Skip to main content

Advertisement

SpringerLink
Log in

Mucosal Melanomas of the Head and Neck—a Tertiary Cancer Centre Experience

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Mucosal melanoma is a relatively rare tumour of the head and neck with a very poor prognosis. Managing this disease entity becomes more difficult due to high chances of disease failure locoregionally and at distant sites. This study assessed the treatment outcomes and factors affecting prognosis of head and neck mucosal melanomas. Forty-one cases of mucosal melanomas of head and neck (MMHN) treated in our institution during 10 years were retrospectively reviewed. Data regarding the clinicopathological parameters and treatment outcomes was collected. Survival was calculated using Kaplan-Meier method. The most common subsite of MMHN was upper alveolus and hard palate (39%). Thirty-one of the 41 cases underwent surgery whereas 10 cases were treated with palliative intent. At presentation, 15 of 41 cases had lymph node involvement and majority of them had primary in the oral cavity: sinonasal region had low chances of lymph node metastasis. Seventy-four percent of cases underwent adjuvant post-operative radiotherapy. For surgically treated cases, 5-year disease-specific survival (DSS) was 35.7%. Mucosal melanomas of nose and paranasal sinuses had a better overall survival than oral cavity. Distant metastasis was the most common cause of disease failure in 12 of 24 cases and had a significant association with disease-specific survival. The stage of the disease was a significant prognostic indicator. Sinonasal cavity mucosal melanomas have a better prognosis than mucosal melanomas in other subsites. Overall survival for surgically treated cases was significantly better than cases treated non-surgically. Presence of lymph node metastasis reduced the survival by 50% in MMHN.

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

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Weber CO (1859) Surgical experience and research, in addition to interesting observations from the Surgical Clinic and the Protestant Hospital Bonn. G. Reimer, Berlin, pp 304–305

    Google Scholar 

  2. Lourenco SV, Sangueza AM, Sotto MN et al (2009) Primary oral mucosal melanoma: a series of 35 new cases from South America. Am J Dermatopathol 31:323–330

    Article  Google Scholar 

  3. Moreno MA, Roberts DB, Kupferman ME et al (2010) Mucosal melanoma of the nose and paranasal sinuses, a contemporary experience from the M. D Anderson Cancer Center. Cancer 116:2215–2223

    PubMed  Google Scholar 

  4. Jangard M, Hansson J, Ragnarsson-Olding B (2013) Primary sinonasal malignant melanoma: a nationwide study of the Swedish population, 1960–2000. Rhinology. 51:22–30

    Article  CAS  Google Scholar 

  5. McLaughlin CC, Wu XC, Jemal A et al (2005) Incidence of noncutaneous melanomas in the U.S. Cancer 103:1000–1007

    Article  Google Scholar 

  6. Holmstrom M, Lund VJ (1991) Malignant melanomas of the nasal cavity after occupational exposure to formaldehyde. Br J Ind Med 48:9–11

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Satzger I, Schaefer T, Kuettler U, Broecker V, Voelker B, Ostertag H, Kapp A, Gutzmer R (2008) Analysis of c-KIT expression and KIT gene mutation in human mucosal melanomas. Br J Cancer 99:2065–2069

    Article  CAS  Google Scholar 

  8. Lourenco SV, Fernandes JD, Hsieh R et al (2014) Head and neck mucosal melanoma: a review. Am J Dermatopathol 36:578–587

    Article  Google Scholar 

  9. Turri-Zanoni M, Medicina D, Lombardi D et al (2013) Sinonasal mucosal melanoma: molecular profile and therapeutic implications from a series of 32 cases. Head Neck 35:1066–1077

    Article  Google Scholar 

  10. Suzuki N, Onda T, Yamamoto N, Katakura A, Mizoe JE, Shibahara T (2007) Mutation of the p16/CDKN2gene and loss of heterozygosity in malignant mucosal melanoma and adenoid cystic carcinoma of the head and neck. Int J Oncol 31:1061–1067

    CAS  PubMed  Google Scholar 

  11. Hsieh R, Nico MM, Coutinho–Camillo CM, et al. The CDKN2A and MAP kinase pathways: molecular roads to primary oral mucosal melanoma. Am J Dermatopathol 2013; 35:167–175

  12. Tanaka N, Odajima T, Mimura M, Ogi K, Dehari H, Kimijima Y, Kohama G (2001) Expression of Rb, pRb2/p130, p53, and p16 proteins in malignant melanoma of oral mucosa. Oral Oncol 37:308–314

    Article  CAS  Google Scholar 

  13. Patel SG, Prasad ML, Escrig M, Singh B, Shaha AR, Kraus DH, Boyle JO, Huvos AG, Busam K, Shah JP (2002) Primary mucosal malignant melanoma of the head and neck. Head Neck. 24:247–257

    Article  Google Scholar 

  14. Mendenhall WM, Amdur RJ, Hinerman RW, Werning JW, Villaret DB, Mendenhall NP (2005) Head and neck mucosal melanoma. Am J Clin Oncol 28:626–630

    Article  Google Scholar 

  15. Guevara-Canales JO, Gutiérrez-Morales MM, Sacsaquispe-Contreras SJ et al (2012) Malignant melanoma of the oral cavity. Review of the literature and experience in a Peruvian population. Med Oral Patol Oral Cir Bucal 17:206–211

    Article  Google Scholar 

  16. Umeda M, Shimada K (1994) Primary malignant melanoma of the oral cavity—its histological classification and treatment. Br J Oral Maxillofac Surg 32:39–47

    Article  CAS  Google Scholar 

  17. Terada T, Saeki N, Toh K, Uwa N, Sagawa K, Mouri T, Sakagami M (2007) Primary malignant melanoma of the larynx: a case report and literature review. Auris Nasus Larynx 34:105–110

    Article  Google Scholar 

  18. Franchi A, Alos L, Gale N, Massi D, Paglierani M, Santucci M, Zidar N, Cardesa A (2006) Expression of p16 in sinonasal malignant melanoma. Virchows Arch 449:667–672

    Article  CAS  Google Scholar 

  19. Medina JE, Ferlito A, Pellitteri PK, Shaha AR, Khafif A, Devaney KO, Fisher SR, O'Brien CJ, Byers RM, Robbins KT, Pitman KT, Rinaldo A (2003) Current management of mucosal melanoma of the head and neck. J Surg Oncol 83:116–122

    Article  Google Scholar 

  20. Krengli M, Masini L, Kaanders JH et al (2006) Radiotherapy in the treatment of mucosal melanoma of the upper aerodigestive tract: analysis of 74 cases. A rare cancer network study. Int J Radiat Oncol Biol Phys 65:751–759

    Article  Google Scholar 

  21. Nandapalan R, Helliwell et al (1998) Mucosal melanoma of the head and neck. Clin Otolaryngol Allied Sci 23:107–116

    Article  CAS  Google Scholar 

  22. Bartell HL, Bedikian AY, Papadopoulos NE, Dett TK, Ballo MT, Myers JN, Hwu P, Kim KB (2008) Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck 30:1592–1598

    Article  Google Scholar 

  23. Ives NJ, Stowe RL, Lorigan P et al (2007) Chemotherapy compared with biochemotherapy for the treatment of metastatic melanoma: a meta-analysis of 18 trials involving 2,621 patients. J Clin Oncol 25:5426–5434

    Article  CAS  Google Scholar 

  24. Bajetta E, Del Vecchio M, Nova P et al (2006) Multicenter phase III randomized trial of polychemotherapy (CVD regimen) versus the same chemotherapy (CT) plus subcutaneous interleukin-2 and interferon-alpha2b in metastatic melanoma. Ann Oncol 17:571–577

    Article  CAS  Google Scholar 

  25. Valsecchi ME, Sato T (2013) The potential role of sunitinib targeting melanomas. Expert Opin Investig Drugs 22:1473–1483

    Article  CAS  Google Scholar 

  26. Carvajal RD, Antonescu CR, Wolchok JD, Chapman PB, Roman RA, Teitcher J, Panageas KS, Busam KJ, Chmielowski B, Lutzky J, Pavlick AC, Fusco A, Cane L, Takebe N, Vemula S, Bouvier N, Bastian BC, Schwartz GK (2011) KIT as a therapeutic target in metastatic melanoma. JAMA. 305:2327–2334

    Article  CAS  Google Scholar 

  27. Plavc G, But-Hadzic J, Anicin A et al (2016) Mucosal melanoma of the head and neck: a population-based study from Slovenia, 1985-2013. Radiat Oncol 11:137

    Article  Google Scholar 

Download references

Acknowledgements

We take this opportunity to thank the faculty, fellows, post graduates and staff of the Department of Head & Neck Surgery for their whole-hearted cooperation in completion of this study. We also express our gratitude to the staff of the medical records department for providing us case records to acquire data for this study.

Funding

There is no funding for this research work.

Author information

Authors and Affiliations

  1. Department of Head & Neck Surgery, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    Sandeep Suresh, Nebu Abraham George, Deepak Janardhan, Shirish Patil, Ciju K. George & Bipin T. Varghese

  2. Department of Epidemiology and Biostatistics, Regional Cancer Centre, Thiruvananthapuram, Kerala, India

    Preethi Sara George & J. V. Ammu

Authors
  1. Sandeep Suresh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nebu Abraham George
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Deepak Janardhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Preethi Sara George
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shirish Patil
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ciju K. George
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bipin T. Varghese
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. V. Ammu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nebu Abraham George.

Ethics declarations

Ethical Statement

There was adherence to the ethical standards in this study.

Conflict of Interest

The authors declare that they have no conflict of interest (Financial / Non-financial).

Institutional Review Board Approval

All procedures performed in studies were in accordance with the IRB standards of Regional Cancer Centre, Thiruvanathapuram approved by the Institutional Review Board.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suresh, S., George, N.A., Janardhan, D. et al. Mucosal Melanomas of the Head and Neck—a Tertiary Cancer Centre Experience. Indian J Surg 82, 625–631 (2020). https://doi.org/10.1007/s12262-020-02082-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-020-02082-5

Keywords

Search

Navigation