Mucosal Melanoma in the Head and Neck Region: Different Clinical Features and Same Outcome to Cutaneous Melanoma

Mucosal melanoma (MM) in the head and neck (H&N) is relatively rare and behaves in distinct pattern from cutaneous melanoma (CM). We performed this study to define clinical characteristics and outcomes of patients and emphasize MM differences from CM. Forty-one patients with MM located in H&N were assessed. 94 CM patients originated from H&N region were also used for comparison. Patients had oral cavity (51%) and sinonasal location (49%).The median age was 60 years and gender distribution was equal. Thirty-two (78%) patients had localized stage, four (10%) patients had regional lymph node metastasis, and five (12%) patients had distant metastasis. The 1- and 5-year overall survival rates were 81% and 58%, respectively. Outcomes were similar between sinonasal and oral cavity patients ( ). Advanced disease was the significant prognostic factor for outcome ( ). MM patients are older ( ) and more diagnosed as a localized disease patients at presentation than those with CM ( ). Overall survival rates were identical in patients with MM and CM ( ). In conclusion, despite different clinical features, outcome was identical in patients with MM and CM located in the H&N region. 1. Introduction Melanomas develop from melanocytes which are derived from the neural crest and are widely distributed throughout all cutaneous, ocular, and most of the mucosal surfaces. Cutaneous melanomas (CMs) are much more prevalent than noncutaneous melanomas, which are comprised of mucosal, ocular, and unknown primaries [1]. The annual age-adjusted incidence of noncutaneous melanomas was reported 0.7 per 100？000 persons. The vast majority of these tumors (approximately 80%) were ocular in origin. The remaining arose in the mucosa, resulting in an annual incidence of only 0.15 per 100？000 persons and accounting for nearly 3-4% of all melanoma diagnosed yearly [1, 2]. Likewise, Cancer Control Agency of British Columbia revealed a similar 4.5% of all melanoma patients who were diagnosed with a mucosal primary tumor [1, 3]. Based on the analyses of the National Cancer Data Base (NCDB) that comprised 84？836 cutaneous and noncutaneous melanoma cases, the percentages of mucosal melanoma (MM) were 1.3% [1, 4]. While it is a rare neoplasm of melanocytic origin, the head and neck (H&N) are the most common sites for MM, representing nearly half of MMs from all sites [1, 5, 6]. Additionally, it also accounts for approximately 1-2% of all melanomas and 2–8 of all H&N melanomas. It involves in decreasing order of frequency the sinonasal cavity (50%), oral cavity (45%), and other sites (5%) such as