Neck dissection for oral mucosal melanoma: Caution of nodular lesion

Wu, Yongwei; Zhong, Yi; Li, Chao‐Jun; Song, Hao; Guo, Wei; Ren, Guoxin

doi:10.1016/j.oraloncology.2014.01.008

Cited by 40 publications

(42 citation statements)

References 33 publications

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“…Cryotherapy was initially suggested to treat superficial lesions. Prophylactic, functional, or radical neck dissection was performed for different patients [18, 19]. Post-operative chemotherapy was performed every 3 weeks for 2 cycles in CN0 patients and for 4 cycles in CLN positive patients.…”

Section: Methodsmentioning

confidence: 99%

Loss of nuclear BAP1 expression is associated with poor prognosis in oral mucosal melanoma

et al. 2017

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Oral mucosal melanoma (OMM) is an aggressive neoplasm with an extremely poor prognosis. BAP1 is a tumor suppressor that has been associated with the outcome of melanomas and other malignancies. In this study, we investigated the genetic alterations in BAP1 and the prognostic potential of BAP1 protein expression in oral mucosal melanoma. DNA sequence analysis of BAP1 from 12 OMM patient samples revealed missense mutations in the tissues from four patients. Based on immunohistochemical staining, loss of nuclear BAP1 expression was associated with poor overall survival (P < 0.001, Log-rank = 21.308) and distant metastasis (P = 0.034, OR = 0.320). Multivariate analysis showed BAP1 to be an independent prognostic factor (P = 0.027, HR = 0.479). It thus appears that loss of nuclear BAP1 expression is an independent prognostic factor of poor overall survival and associated with distant metastasis in OMM.

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Section: Methodsmentioning

confidence: 99%

Loss of nuclear BAP1 expression is associated with poor prognosis in oral mucosal melanoma

et al. 2017

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“…The macroscopic appearance of oral PMMs has been found to correlate with the risk of developing regional metastases. Based on this finding, it may be advisable for patients with clinically nodular oral melanomas to undergo prophylactic neck dissection; close follow‐up may be acceptable for patients with flattened/macular oral PMMs . Sentinel lymph node biopsy may provide an alternative to identify patients who could benefit from an elective neck dissection.…”

Section: Treatmentmentioning

confidence: 99%

Update on primary head and neck mucosal melanoma

et al. 2015

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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.

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“…Wuet al suggested that the patients with cN0 nodular melanomas should have prophylactic neck lymph node dissection, while close observation is recommended for patients with cN0 macular melanomas. The patients with metastaticcervical lymph nodes should undergo radical neck resection [18]. On the contrary, Tanaka et al [19] supported the viewpoint of Blatchford et al [20] brown, gray, purple and red.…”

Section: Discussionmentioning

confidence: 96%

Oral Mucosa Malignant Melanoma: Clinical Features, Diagnosis, Treatment, and a Case Report

Huang¹

2015

J Dent Probl Solut

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Primary oral mucosa malignant melanoma is a rare and biologically aggressive neoplasm. It is estimated about 1~2% of all oral malignancies with the incidence increasing with age. The prognosis of oral mucosa malignant melanoma is poor with the five-year survival rate is approximately 15%. The diagnosis of oral melanoma is usually delayed because it is always asymptomatic at the beginning and it resembles the epulis, amalgam tattoo or other oral lesions. In addition, nearly a third of all oral melanoma are amelanotic and may lack a radial growth phase, which makes early and accurate diagnosis even difficult. Thus, regional and distant metastases happen more frequently. Surgery is the first choice of treatment, and clinically negative necklymph nodes with neck dissection or radiotherapy are also recommended because of the high risk of subclinical regional metastasis.In this article, we reviewed the clinical features, diagnosis, treatment, and presented a 70 y/o male who suffered from an easily bleeding lesion over right posterior palatal mucosa and gingiva who presented at hospital for help. We performed biopsy which revealed a malignant melanoma. He received supraomohyoid neck lymph node dissection, partial maxillectomy, and was reconstructed with anterior lateral thigh free fascia cutaneous flap. After surgical treatment, the patient kept regular follow-ups. The treatment outcome was good and the patient recovered with full swallowing and phonation function.components. In some cases, they may have no melanin production (amelanotic melanoma). This may also be one of the challenges to make an accurate diagnosis because melanoma can mimic a variety of undifferentiated tumors. Histological differential diagnoses included malignant lymphoma, amelanotic melanoma, spindle cell malignancies of mesenchymal tissues, and undifferentiated carcinoma. Immunohistochemical studies such as S-100 protein, HMB-45, Melan-A and Mart-1 reactivity of the tumor cells are beneficial in distinguishing such melanomas from other malignancies [4].The prognosis of oral mucosa malignant melanoma is extremely poor in relationship to its cutaneous counterpart. The 5-year survival rate is around 13%~22%. It may be resulted from delayed diagnosis and treatment, the aggressive nature of the disease, difficulty in achieving wide resection and a tendency for early hematogenous metastasis. Therapy of oral mucosa malignant melanoma is commonly based on surgical excision of the primary tumor, but it may be challenge depending on the anatomic location within the oral cavity and extent of tumor. Although melanoma is traditionally considered to be radioresistant, some authors have described improved survival and local control with postoperative radiotherapy [1,4]. In some studies, chemotherapy and immunotherapy are served as adjunctive therapies. However, there are still no guidelines or consensus in treatment of oral mucosa malignant melanoma. In this article, we reported a case of primary oral mucosa malignant melanoma over right maxillary gingi...

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Neck dissection for oral mucosal melanoma: Caution of nodular lesion

Cited by 40 publications

References 33 publications

Loss of nuclear BAP1 expression is associated with poor prognosis in oral mucosal melanoma

Loss of nuclear BAP1 expression is associated with poor prognosis in oral mucosal melanoma

Update on primary head and neck mucosal melanoma

Oral Mucosa Malignant Melanoma: Clinical Features, Diagnosis, Treatment, and a Case Report

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