Mucosal melanoma

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Mucosal melanoma
Mucosal melanoma of the palate
Synonyms N/A
Pronounce N/A
Specialty N/A
Symptoms Nasal obstruction, epistaxis, oral bleeding, dysphagia, pain
Complications Metastasis, local invasion
Onset Typically in adulthood
Duration Chronic
Types Head and neck, gastrointestinal tract, genitourinary tract
Causes Genetic mutations, environmental factors
Risks Age, genetic predisposition, previous melanoma
Diagnosis Biopsy, imaging studies
Differential diagnosis Squamous cell carcinoma, adenocarcinoma, lymphoma
Prevention None specific
Treatment Surgery, radiation therapy, immunotherapy
Medication Immune checkpoint inhibitors, targeted therapy
Prognosis Generally poor, varies by stage and location
Frequency Rare, <1% of all melanomas
Deaths N/A


A rare form of melanoma occurring on mucosal surfaces


Mucosal melanoma is a rare and aggressive form of melanoma that occurs on the mucous membranes of the body. Unlike the more common cutaneous melanoma, which arises from the skin, mucosal melanoma develops in the mucosal tissues lining the respiratory, gastrointestinal, and urogenital tracts.

Epidemiology

Mucosal melanoma accounts for approximately 1% of all melanoma cases. It is most commonly diagnosed in individuals over the age of 60, with a slight female predominance. The incidence of mucosal melanoma is higher in certain populations, including those of Asian and African descent.

Pathophysiology

Mucosal melanoma arises from the malignant transformation of melanocytes located in the mucosal tissues. These melanocytes are responsible for the production of melanin, the pigment that gives color to the skin, hair, and eyes. The exact cause of mucosal melanoma is not well understood, but it is believed to involve a combination of genetic and environmental factors.

Clinical Presentation

The symptoms of mucosal melanoma vary depending on the location of the tumor. Common sites include the nasal cavity, oral cavity, anorectal region, and vulvovaginal area. Symptoms may include nasal obstruction, epistaxis (nosebleeds), oral lesions, rectal bleeding, and vaginal discharge. Due to its location, mucosal melanoma is often diagnosed at a later stage than cutaneous melanoma.

Diagnosis

Diagnosis of mucosal melanoma involves a combination of clinical examination, imaging studies, and histopathological analysis. Biopsy of the lesion is essential for confirming the diagnosis. Imaging techniques such as CT and MRI may be used to assess the extent of the disease and detect metastases.

Treatment

The treatment of mucosal melanoma is challenging due to its aggressive nature and tendency for late diagnosis. Surgical resection remains the primary treatment modality, often followed by radiotherapy or chemotherapy. Recent advances in immunotherapy and targeted therapy have shown promise in the management of advanced mucosal melanoma.

Prognosis

The prognosis for mucosal melanoma is generally poor compared to cutaneous melanoma. The five-year survival rate is significantly lower, largely due to the advanced stage at diagnosis and the aggressive behavior of the tumor. Early detection and treatment are crucial for improving outcomes.

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Contributors: Prab R. Tumpati, MD