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Head Neck. 2016 Jan;38(1):147-55. doi: 10.1002/hed.23872. Epub 2015 May 22.

Update on primary head and neck mucosal melanoma.

Author information

1
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
2
Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.
3
Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain.
4
Department of Oral Pathology, School of Dentistry, University of Liverpool, Liverpool, United Kingdom.
5
Department of Pathology, Allegiance Health, Jackson, Michigan.
6
Department of Radiation Oncology, University of Florida, Gainesville, Florida.
7
Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
8
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
9
Department of Otolaryngology-Head and Neck Surgery, Guthrie Health System, Sayre, Pennsylvania.
10
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
11
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
12
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
13
Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
14
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
15
University of Udine School of Medicine, Udine, Italy.

Abstract

Primary mucosal melanomas (PMMs) of the head and neck are uncommon malignancies that arise mainly in the nasal cavity and paranasal sinuses, followed by the oral cavity. The mainstay of treatment is radical surgical resection followed by adjuvant radiotherapy in selected patients with high-risk features. Multimodality therapy has not been well studied and is not standardized. Adjuvant radiotherapy seems to improve locoregional control but does not improve overall survival (OS). Elective neck dissection is advocated in patients with oral PMM. Systemic therapy should be considered only for patients with metastatic or unresectable locoregional disease. Despite improvements in the field of surgery, radiotherapy, and systemic therapy, patients with PMM still face a very unfavorable prognosis (5-year disease-free survival [DFS] <20%) with high rates of locoregional recurrence and distant metastasis. The present review aims to summarize the current state of knowledge on the molecular biology, pathological diagnosis, and management of this disease.

KEYWORDS:

chemotherapy; diagnosis; head and neck; mucosal melanoma; outcomes; radiotherapy; staging system; surgery

PMID:
25242350
PMCID:
PMC4986507
DOI:
10.1002/hed.23872
[Indexed for MEDLINE]
Free PMC Article

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