Abstract
Primary oral melanoma (POM) is a rare disease, but is associated with significant mortality. Due to its largely asymptomatic nature, patients with POM often present late and the disease may be locally advanced or have even metastasized at the time of diagnosis. Therefore, having confirmed the diagnosis histologically, staging examinations, including ultrasound of local regional lymph nodes, magnetic resonance imaging, (positron emission) computer tomography and bone scintigraphy are important not only to determine the extent of the disease, but to help guide decisions regarding the nature and extent of surgical intervention. When possible, full surgical resection with clear resection margins is desirable. Lymph node dissection and/or radiotherapy may be considered when lymph nodes are involved. However, evidence that lymph node dissection and/or radiotherapy improve overall survival is lacking, although it may help in securing loco-regional disease control. The treatment of metastatic POM currently centers on the use of immune checkpoint inhibition, although its efficacy remains below that seen in the treatment of metastatic cutaneous melanoma. Further studies are required to gain new insights into disease pathogenesis and to identify much needed novel treatment targets.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Lopez F, et al. Update on primary head and neck mucosal melanoma. Head Neck. 2016;38(1):147–55.
Sortino-Rachou AM, et al. Primary oral melanoma: population-based incidence. Oral Oncol. 2009;45(3):254–8.
Meleti M, et al. Oral malignant melanoma: a review of the literature. Oral Oncol. 2007;43(2):116–21.
Hicks MJ, Flaitz CM. Oral mucosal melanoma: epidemiology and pathobiology. Oral Oncol. 2000;36(2):152–69.
Cohen Goldemberg D, et al. Epidemiological profile of mucosal melanoma in Brazil. Sci Rep. 2020;10(1):505.
Heppt MV, et al. Prognostic factors and treatment outcomes in 444 patients with mucosal melanoma. Eur J Cancer. 2017;81:36–44.
Ozturk Sari S, et al. BRAF, NRAS, KIT, TERT, GNAQ/GNA11 mutation profile analysis of head and neck mucosal melanomas: a study of 42 cases. Pathology. 2017;49(1):55–61.
Satzger I, et al. Analysis of c-KIT expression and KIT gene mutation in human mucosal melanomas. Br J Cancer. 2008;99(12):2065–9.
Lyu J, et al. Mutation scanning of BRAF, NRAS, KIT, and GNAQ/GNA11 in oral mucosal melanoma: a study of 57 cases. J Oral Pathol Med. 2016;45(4):295–301.
Newell F, et al. Whole-genome landscape of mucosal melanoma reveals diverse drivers and therapeutic targets. Nat Commun. 2019;10(1):3163.
Schadendorf D, et al. Melanoma. Lancet. 2018;392(10151):971–84.
Lourenco SV, et al. Head and neck mucosal melanoma: a review. Am J Dermatopathol. 2014;36(7):578–87.
Lambertini M, et al. Oral melanoma and other pigmentations: when to biopsy? J Eur Acad Dermatol Venereol. 2018;32(2):209–14.
Fryer A. Mucosal lesions can occur in leopard syndrome. Clin Dysmorphol. 2007;16(4):277–8.
Aguas SC, et al. Primary melanoma of the oral cavity: ten cases and review of 177 cases from literature. Med Oral Patol Oral Cir Bucal. 2009;14(6):E265–71.
Rambhia PH, Stojanov IJ, Arbesman J. Predominance of oral mucosal melanoma in areas of high mechanical stress. J Am Acad Dermatol. 2019;80(4):1133–5.
Lee G, et al. The prognostic role of the surgical approach and adjuvant therapy in operable mucosal melanoma of the head and neck. Clin Exp Otorhinolaryngol. 2017;10(1):97–103.
Penel N, et al. Primary mucosal melanoma of head and neck: prognostic value of clear margins. Laryngoscope. 2006;116(6):993–5.
Green B, et al. An update on the current management of head and neck mucosal melanoma. J Oral Pathol Med. 2017;46(7):475–9.
Chatzistefanou I, et al. Primary mucosal melanoma of the oral cavity: current therapy and future directions. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(1):17–27.
Li W, et al. Evaluation of the prognostic impact of postoperative adjuvant radiotherapy on head and neck mucosal melanoma: a meta-analysis. BMC Cancer. 2015;15:758.
Lian B, et al. Phase II randomized trial comparing high-dose IFN-alpha2b with temozolomide plus cisplatin as systemic adjuvant therapy for resected mucosal melanoma. Clin Cancer Res. 2013;19(16):4488–98.
Aigner B, et al. Partial response of metastatic mucosal melanoma after palliative chemotherapy with trofosfamide: a case report. J Clin Oncol. 2013;31(2):e31–2.
Terheyden P, Krackhardt A, Eigentler T. The systemic treatment of melanoma. Dtsch Arztebl Int. 2019;116(29–30):497–504.
D'Angelo SP, et al. Efficacy and safety of Nivolumab alone or in combination with Ipilimumab in patients with mucosal melanoma: a pooled analysis. J Clin Oncol. 2017;35(2):226–35.
Sheng X, et al. Axitinib in combination with Toripalimab, a humanized immunoglobulin G4 monoclonal antibody against programmed cell Death-1, in patients with metastatic mucosal melanoma: an open-label phase IB trial. J Clin Oncol. 2019;37(32):2987–99.
Drescher C, et al. Regression of mucosal melanoma following intralesional talimogene laherparepvec (T-VEC) injection in combination with immunotherapy. J Dtsch Dermatol Ges. 2019;17(3):321–3.
Nathan P, et al. Safety and efficacy of nivolumab in patients with rare melanoma subtypes who progressed on or after ipilimumab treatment: a single-arm, open-label, phase II study (CheckMate 172). Eur J Cancer. 2019;119:168–78.
Weber J, et al. Adjuvant Nivolumab versus Ipilimumab in resected stage III or IV melanoma. N Engl J Med. 2017;377(19):1824–35.
Zhou R, et al. Analysis of mucosal melanoma whole-genome landscapes reveals clinically relevant genomic aberrations. Clin Cancer Res. 2019;25(12):3548–60.
Gottesdiener LS, et al. Rates of ERBB2 alterations across melanoma subtypes and a complete response to Trastuzumab Emtansine in an ERBB2-amplified Acral melanoma. Clin Cancer Res. 2018;24(23):5815–9.
Acknowledgments
Sincere thanks to Prof. Dr. Dr. Hendrik Terheyden for providing the clinical images.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Langan, E.A., Terheyden, P. (2021). Melanoma of the Oral Cavity. In: Schmidt, E. (eds) Diseases of the Oral Mucosa. Springer, Cham. https://doi.org/10.1007/978-3-030-82804-2_34
Download citation
DOI: https://doi.org/10.1007/978-3-030-82804-2_34
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-82803-5
Online ISBN: 978-3-030-82804-2
eBook Packages: MedicineMedicine (R0)