Melanomas may arise from the mucosal epithelium lining the respiratory, alimentary, and genitourinary tracts, all of which contain melanocytes, as well as from the skin.
Mucosal melanomas generally carry a worse prognosis than those arising from cutaneous sites. Because of the rarity of mucosal melanoma, and because of the unique biology and clinical challenges of mucosal melanoma arising from each anatomic location, our understanding of these malignancies and their optimal management remains limited.
General aspects of mucosal melanoma, as well as the specific approach to patients with mucosal melanomas arising in the head and neck, vulvovaginal, and anorectal regions, are discussed here.
MUCOSAL VERSUS CUTANEOUS MELANOMA
There are substantial differences in mucosal as opposed to cutaneous melanomas that have important implications for patient management.
Epidemiology — Mucosal melanomas are rare and account for approximately 1 percent of all melanomas . Mucosal melanomas arise primarily in the head and neck, anorectal, and vulvovaginal regions (55, 24, and 18 percent of cases, respectively). Rarer sites of origin include the urinary tract, gall bladder, and small intestine.