Mucosal Melanomas: A Case-Based Review of the Literature

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Differentiate mucosal melanoma from cutaneous melanoma and describe its etiology, molecular features, and treatment approaches in surgical, radiation, and medical oncology.Evaluate mucosal melanoma patients with non-metastatic disease for adjuvant radiation to optimize treatment of the primary tumor.Refer appropriate patients for testing for c-KIT mutations and gene aberrations in order to avoid subjecting them to chemotherapy with minimal benefit. CME This article is available for continuing medical education credit at CME.TheOncologist.com. Mucosal 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.