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Malignant mucosal melanoma of the head and neck
Author(s) -
Manolidis Spiros,
Donald Paul J.
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19971015)80:8<1373::aid-cncr3>3.0.co;2-g
Subject(s) - medicine , mucosal melanoma , melanoma , metastasis , head and neck , distant metastasis , survival rate , lymph node , disease , surgery , oncology , dermatology , radiology , cancer , cancer research
BACKGROUND Fortunately, primary malignant mucosal melanoma of the head and neck is a rare entity. A paucity of data elucidating the predictive factors as well as the unpredictable and aggressive biologic behavior of mucosal melanoma compound the vexing clinical situation. This review summarizes what the literature reveals about the epidemiology, patient survival, patterns of local recurrence, and local and distant metastasis of the disease. Over 1000 patients with this disease have been reported. Survivals at 5 and 10 years is 17% and 5%, respectively. Approximately 19% of patients present with lymph node metastasis and another 16% develop lymph node metastases after treatment, whereas 10% present with distant metastasis. Local metastasis does not affect survival; this is in sharp contrast with skin melanoma. Over 50% of patients experience local treatment failure, and salvage treatment is effective in only 25% of these cases. Local failure is the harbinger of distant metastases. Patients with nasal mucosal melanoma have a 31% 5‐year survival rate, whereas sinus melanoma patients fare poorly, with a 0% rate of 5‐year survival. METHODS The authors conducted a retrospective review of 14 patients with characteristics similar to those in the literature in terms of outcome. RESULTS The 5‐year survival rate for these patients was 14%. Whole‐body positron emission tomography was performed on 3 patients to detect metastatic disease. The patterns of local recurrence, distant metastasis, and survival for these patients were compared with the same data for patients described in the literature. CONCLUSIONS Surgery appears to have the greatest efficacy in the management of mucosal melanoma, although radiation therapy may play an increasingly important role in the future. Cancer 1997; 80:1373‐86. © 1997 American Cancer Society.