Mucosal Melanoma: General Overview

Melanoma Skin Cancer

Author: Thomas C. Weiss
Published: 2010/03/13 - Updated: 2023/01/31
Contents: Summary - Introduction - Main - Related

Synopsis: Mucosal melanoma are lesions that may present as blue to black in color with irregular borders. Malignant melanoma of the skin was formerly associated with a poor prognosis, although that has changed significantly. The year 1950 found the five-year survival rate for malignant skin melanoma at fifty percent; today, that survival rate has reached ninety percent. Mucosal melanoma, however, still has a poor survival rate of not higher than thirty-eight percent.

Introduction

Mucosal melanoma are lesions that may be blue to black with irregular borders. Malignant melanoma, whether present on a person's skin or in their oral cavity, has the same cell of origin; the melanocyte.

The U.S. Social Security Administration (SSA) has included Mucosal Malignant Melanoma as a Compassionate Allowance to expedite a disability claim.

Main Digest

Even though they have the same cell of origin, they present with different clinical behavior, depending upon the location of the melanoma. Malignant melanoma commonly affects adults with an average age of fifty-five. On occasion, they affect people under the age of thirty. A person's tongue is an unusual location for malignant oral melanoma.

Malignant melanoma of the skin was formerly associated with a poor prognosis, although that has changed significantly. The year 1950 found the five-year survival rate for malignant skin melanoma at fifty percent; today, that survival rate has reached ninety percent. Mucosal melanoma still has a poor survival rate of not higher than thirty-eight percent. Skin malignant melanoma, as with mucosal melanoma, occurs largely in the adult population in persons around fifty years of age, rarely affecting children.

People with malignant oral mucosal melanoma find them largely 'asymptomatic,' meaning they do not experience any associated symptoms. Oral mucosal melanomas are malignant tumors with a 'chameleonic' presentation and a poor prognosis. Treatment of oral mucosal melanomas is highly specialized, with factors that need to be seriously considered by the person's health care provider. Melanomas from oral mucosa have a poor prognosis unless they are discovered and treated early.

Fortunately, primary mucosal melanomas involving a person's head and neck are rare, occurring less frequently than melanomas of the skin. Among melanomas of the neck and head region, oral mucosal melanomas are highly infrequent, accounting for a mere half of one percent of all oral neoplasms. Oral mucosal melanomas are highly malignant tumors that tend to 'metastasize' or spread to tissues more easily than other malignant tumors involving a person's oral cavity. Approximately one-third of people do not experience any symptoms whatsoever when they are diagnosed. Episodes of bleeding appear to be the top symptoms that people do end up experiencing.

Cutaneous malignant melanoma is the third most common skin epithelial malignancy, following basal cell carcinoma and squamous cell carcinoma, and is the most aggressive. In America, more than fifty thousand people are diagnosed yearly, with around eight thousand dying from the disease yearly. The disease has been increasing since 1960, although it has recently plateaued. The 1960s found approximately one in every six-hundred people expected to develop malignant melanoma during their lifetime, compared to one in one hundred and seventy-one in 2001. Australia has the highest number of malignant skin melanomas; the number of people experiencing them there has doubled yearly for a decade. The etiology of malignant melanoma and its rate of increase are complex. Multiple factors appear to play a role in developing malignant melanoma and its progression. The greatest factor is exposure to ultraviolet light, something that explains malignant melanoma on the skin yet does not explain oral, nasal, or other forms of malignant melanoma that are not due to sun exposure.

A suggestion has been made that the age of the person at the time of exposure is relevant and important. Another suggestion that has been made is that sunburns, particularly blistering sunburns during a person's childhood, increase the risk a person has of developing malignant melanoma during adulthood. A person's genetics play a significant role in malignant melanoma, especially in people born in families with a history of the disease. For example, people with family members with a history of dysplastic mole syndrome or a first relative with malignant melanoma are at greater risk of developing the disease. Approximately seventy percent of cutaneous malignant melanomas occur in pre-existing pigmented nevus, which is common. Pigmented nevus presents a one-in-a-million chance of transforming into malignant melanoma. While this does not mean there is a need to have them surgically removed, it does suggest that healthcare workers should be attentive to alterations in nevi, including changes in their shape, size, or color. Healthcare workers should also look for any bleeding or ulceration of nevi, pain, inflammation, or a diameter change of greater than 7mm.

A person's oral mucosa is rarely affected by malignant melanoma. Because of this, the etiology of oral malignant melanoma remains unclear. Tobacco use has been associated with oral mucosal malignant melanoma. A person's race is something else that seems to play a role. For example, seven and a half percent of all persons with oral melanomas are people of Japanese descent, while ten percent are Ugandan descent; one percent of people affected are Caucasians. Cutaneous malignant melanoma, on the other hand, is something that occurs at a far greater rate among the Caucasian population than in other populations, with a rate of one in eighty-three in whites compared to one in one-thousand, one-hundred and seventy-six in persons of color. Mucosal melanomas are sporadic compared to cutaneous melanomas, constituting a mere one percent of all malignant melanomas.

Criteria used in England to assess the clinical presentation of malignant melanoma include any bleeding or ulceration of a pigmented nevus. The lesion should be biopsied, removed, and submitted for microscopic examination. America follows the 'ABCDE' rule; Asymmetry, Borders, Color, Diameter, and Enlargement about nevus involved. A pigmented lesion that is asymmetrical with irregular borders and uneven coloration that is larger than 6mm in diameter and continues to enlarge should be viewed promptly with suspicion and biopsied promptly.

Eighty percent of oral malignant melanomas affect the person's palate and maxillary gingival. Mandibular gingival may also be affected, although this is a rare occurrence. Cutaneous malignant melanomas occur largely on the interscapular area of a person's back or legs. Around twenty-five percent occur in the person's neck and head area, including their eyes, nose, face, and mouth. Should a malignant melanoma affect a person's mouth, the present is flat, multiple, graded, or with uneven coloration and irregular borders. At times they may be ulcerated as well. Oral malignant melanoma is commonly asymptomatic and does not cause pain, growing in radial and vertical patterns. People affected by malignant melanoma have a prognosis that depends on their location, age, and gender. Treatment may involve surgery, radiation, or chemotherapy.

Author Credentials:

Thomas C. Weiss is a researcher and editor for Disabled World. Thomas attended college and university courses earning a Masters, Bachelors and two Associate degrees, as well as pursing Disability Studies. As a Nursing Assistant Thomas has assisted people from a variety of racial, religious, gender, class, and age groups by providing care for people with all forms of disabilities from Multiple Sclerosis to Parkinson's; para and quadriplegia to Spina Bifida. Explore Thomas' complete biography for comprehensive insights into his background, expertise, and accomplishments.

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Cite This Page (APA): Weiss, T. C. (2010, March 13 - Last revised: 2023, January 31). Mucosal Melanoma: General Overview. Disabled World. Retrieved July 20, 2024 from www.disabled-world.com/health/cancer/melanoma/mucosal-melanoma.php

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