Primary melanoma of the oral mucosa. Experience of a oncology hospital

Jaime Alonso Reséndiz-Colosia; Alma Gabriela Valenzuela-Flores; Francisco José Gallegos-Hernández; Rutilio Flores-Díaz; Sinhué Barroso-Bravo; Sergio Arturo Rodríguez-Cuevas

2007, Number 4

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Cir Cir 2007; 75 (4)

Primary melanoma of the oral mucosa. Experience of a oncology hospital

Reséndiz-Colosia JA, Valenzuela-Flores AG, Gallegos-Hernández FJ, Flores-Díaz R, Barroso-Bravo S, Rodríguez-Cuevas SA

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Language: Spanish
References: 32
Page: 257-262
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ABSTRACT

Background: Primary intraoral melanoma is extremely rare and carries a poor prognosis. Treatment of choice remains controversial. Our aim was to define the clinical features of this disease and to evaluate treatment methods.
Methods. We retrospectively studied 14 patients with primary malignant melanoma of the oral cavity seen at the Oncology Hospital of the Mexican Institute of Social Security (IMSS), 21st Century National Medical Center (CMN-SXXI) between 1991 and 2005. The main variables studied were clinical findings, response to therapy, and outcome.
Results: In five males (35.7 %) and nine females (64.3 %) with a mean age of 65 years, tumor locations included hard palate (nine cases), maxillary gingiva (three cases), hard/soft palate (one case) and lip (one case). Pre-existing melanotic pigmentation was present in two patients. Nine patients were in stage I, four in stage II, and one was in stage III. Surgical excision was the primary treatment in 11 cases; four patients underwent simultaneous neck dissections. All patients in stage II received adjuvant radiation therapy. After a 3-year follow-up, three patients of those presenting stage I are still alive (33.3 %, 3/9 cases), and all patients in stages II and III eventually died of the disease.
Conclusions. Early diagnosis of pigmented lesions in the mouth along with adequate tumor resection may improve the prognosis of this disease; however, in advanced disease stage it may be reasonable to infer that major improvements in outcome after treatment of malignant melanoma of the oral cavity may not be carried out until more effective systemic therapy becomes available.

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