Mucosal Melanomas of the Head and Neck

Overview

Mucosal melanomas are as compared with melanomas of the skin relatively rare. Only0.5 - 2% of all melanomas are on mucous membranes. In the area of the head and neck this appliesin particular to the area of the nasal cavity and paranasal sinuses and the oral cavity. The chieftherapeutic procedure is radical removal of the tumour, but the presence of tumours in these areasmakes surgical excision difficult. Surgical treatment is followed by actinotherapy, possibly immu-nochemotherapy.Due to the small number of hitherto published papers reporting on very small groups of patients,or rather a few cases, the concept of treatment is far from uniform. In the submitted report theauthors analyzed the clinical course of the disease in 17 patients who developed a mucosal melanoma in the area of the head and neck during the period of 1980 - 1998. They made a retrospectiveanalysis of the course of the disease, of lymphogenic and haematogenic secondaries and the type oftreatment. The tumour was six times on the lateral nasal wall, fourtimes on the septum and one caseeach in the maxillary sinus, the ethmoidal sinus, the epipharynx, in the lacrimal sac in the tonsilland in twice the hypopharynx.From the total number of 17 patients 10 were treated primarily by surgery, one by radiotherapy andthree by chemotherapy. In three patients only diagnostic surgery was performed. Primarily theoperation was supplemented in two patients by cervical bloc dissection. Surgical treatment wasfollowed by actinotherapy and in three cases by chemotherapy. After primary radiotherapy surgicaltreatment with subsequent chemotherapy was indicated. Primary chemotherapy was followedtwice by surgical treatment. In the total number of nine recurrences the authors selected asa further therapeutic modality five times surgery and four times chemotherapy. When chemotherapy was indicated it was as a rule combined with Khayat’s immunotherapy. In some instances othercytostatics were administered, or combinations of cytostatics. From the total number 40% patientssurvive for longer than three years, regardless of the provided treatment.

Key words:
malignant melanoma, mucosal melanoma.