Oral malignant melanoma treated with Mohs micrographic surgery by fixed-tissue technique

We describe a 77-year-old man with stage III oral malignant melanoma (Breslow thickness, 4.0 mm) treated with Mohs micrographic surgery by fixed-tissue technique, elective lymph node dissection, and postoperative radiation therapy. This treatment plan permitted complete excision of the melanomatous field, sparing the need for radical resection. Although the patient later died of widespread metastases, there was no evidence of local or regional recurrence and his quality of life was preserved. We believe that Mohs micrographic surgery by fixed-tissue technique followed by radiation therapy offers a safe and alternative treatment option for deep melanomas in the oral cavity.