Cancer, Oral Melanoma

Melanocytes arise from neural crest cells and are frequently found in the skin. However, melanocytes are also found in mucosal membranes. Melanocytes in mucosal membranes are distributed to the oral cavity, nasal cavity, paranasal sinuses, esophagus, larynx, vagina, cervix, rectum, and anus. Melanoma results from a malignant change of melanocytes. Melanoma in the head and neck account for upward of 25% of all melanomas. Mucosal melanomas account for less than 1% of all melanoma. However, mucosal melanoma accounts for roughly 10% of melanoma of the head and neck. The most common sites for mucosal melanoma in order are nasal, paranasal sinuses, oral cavity, and nasopharynx. Of all mucosal melanomas, paranasal sinus has the worst prognosis. The best prognosis locations are the nasal and oral cavity. In 1885, the first case of oral melanoma was reported. Approximately 80% of oral malignant melanomas develop in the mucosa of the upper jaws (maxillary anterior gingiva). The majority of these lesions occur in the keratinizing mucosa of the palate and alveolar gingivae. Lesions are frequently asymptomatic until ulceration and hemorrhage are present. Compared with other melanomas, mucosal melanomas have the lowest percentage of 5-year survival. There is a poor 5-year survival at approximately 15% to 30% likely due to delayed detection.