Mucosal Melanomas: A Case-Based Review of the Literature

Abstract

After completing this course, the reader will be able to:1. Differentiate mucosal melanoma from cutaneous melanoma and describe its etiology, molecular features, and treatment approaches in surgical, radiation, and medical oncology.2. Evaluate mucosal melanoma patients with non-metastatic disease for adjuvant radiation to optimize treatment of the primary tumor.3. Refer appropriate patients for testing for c-KIT mutations and gene aberrations in order to avoid subjecting them to chemotherapy with minimal benefit.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTMucosal melanoma is a rare cancer that is clearly distinct from its cutaneous counterpart in biology, clinical course, and prognosis. Recent studies have shown important differences in the frequencies of various genetic alterations in different subtypes of melanoma. Activating mutations in the c-KIT gene are detected in a significant number of patients with mucosal melanoma. This observation has resulted in the initiation of several clinical trials aimed at exploring the role of receptor tyrosine kinases that inhibit c-KIT in this patient population. We herein present a comprehensive literature review of mucosal melanoma along with case vignettes of a number of pertinent cases. We further discuss melanomas of the head and neck, the female genital tract, and the anorectum, which are the three most common sites of mucosal melanoma, with a particular focus on the diagnostic, prognostic, and therapeutic data available in the literature. The Oncologist 2010;15:772-781

Primary sinonasal mucosal melanoma – Case report and literature review

“…The nasal cavity is the predominant location, approximately 80% of the melanomas arising from the sinonasal tract and 20% developing in the paranasal sinuses 4 . The most frequent sites of origin are represented by the nasal septum and the lateral wall of the nasal cavity, while the maxillary and the ethmoid sinuses are the most common in what the paranasal sinuses are concerned 15 .…”

“…The most frequent sites of origin are represented by the nasal septum and the lateral wall of the nasal cavity, while the maxillary and the ethmoid sinuses are the most common in what the paranasal sinuses are concerned 15 . The exact origin of sinonasal lesions is often difficult to pinpoint mainly because this tumor can spread into multiple subsites and it is frequently locally advanced at presentation 4 . The most common presenting complaints are nasal obstruction and epistaxis.…”

“…The most common presenting complaints are nasal obstruction and epistaxis. Other symptoms are represented by diplopia and proptosis 4 . Nasal obstruction is usually unilateral, permanent and progressive, frequently associated with other symptoms, while epistaxis can be abundant or minimal 12 .…”

“…Etiopathogenesis is relatively poorly understood, but it is a known fact that their origin lies in the melanocytes present in the mucosa of the nasal cavity and paranasal sinuses 3 .The nasal cavity is the most frequent location (80%), especially the lateral wall of the nasal cavity, according to recent literature, with only 20% involvement of the paranasal sinuses 4 . The most frequent clinical symptoms reported are epistaxis and nasal obstruction, but these are hardly specific features.…”

Melanoma of the penis and urethra: literature review and observations from clinical practice

“…На сегодня этиология возникновения меланомы слизистой оболочки неиз-вестна. Ряд авторов видят причину в дисонтогенезе или миграции меланоцитов в область головки полово-го члена [9]. Следует признать, что по причине малого числа пациентов и отсутствия данных рандомизиро-ванных исследований до сих пор нет стандартов диаг-ностики и хирургического лечения и рекомендаций по лекарственной терапии такого агрессивно текуще-го злокачественного заболевания.…”