Primary mucosal malignant melanoma of the head and neck

Diagnosis, therapy, and prognosis of 40 patients with malignant melanoma of the mucous membranes, treated at one hospital from 1971 to 2006, were evaluated in a retrospective study. The survival rate was compared with that established by the German-Austrian-Swiss Study Group on Tumors of the Head and Neck (DÖSAK) for 121 cases. The cumulated 5-year survival rate amounting to 33% (DÖSAK study 35%) emphasizes the unfavorable prognosis of this tumor. Age, sex, or tumor location had no significant impact on a patient's survival. A modified surgical concept has been developed for the treatment of the primary tumor and its lymphatic drainage area to maintain a patient's quality of life. The entire tumor should be resected under histologic control ensuring a 5-mm safety margin of healthy tissue. Bone should only be resected if invaded by the tumor. Large resections of the upper or lower jaw should be avoided. A neck dissection does not improve the prognosis and should be performed only in the case of histologically confirmed invasion of lymph nodes.