[Primary melanoma of the oral mucosa. Experience of the Oncology Hospital of Centro Médico Nacional Siglo XXI].
BACKGROUND
Primary intraoral melanoma is extremely rare and carries a poor prognosis. Treatment of choice remains controversial. Our aim was to define the clinical features of this disease and to evaluate treatment methods.


METHODS
We retrospectively studied 14 patients with primary malignant melanoma of the oral cavity seen at the Oncology Hospital of the Mexican Institute of Social Security (IMSS), 21st Century National Medical Center (CMN-SXXI) between 1991 and 2005. The main variables studied were clinical findings, response to therapy, and outcome.


RESULTS
In five males (35.7%) and nine females (64.3%) with a mean age of 65 years, tumor locations included hard palate (nine cases), maxillary gingiva (three cases), hard/soft palate (one case) and lip (one case). Pre-existing melanotic pigmentation was present in two patients. Nine patients were in stage I, four in stage II, and one was in stage III. Surgical excision was the primary treatment in 11 cases; four patients underwent simultaneous neck dissections. All patients in stage II received adjuvant radiation therapy. After a 3-year follow-up, three patients of those presenting stage I are still alive (33.3%, 3/9 cases), and all patients in stages II and III eventually died of the disease.


CONCLUSIONS
Early diagnosis of pigmented lesions in the mouth along with adequate tumor resection may improve the prognosis of this disease; however, in advanced disease stage it may be reasonable to infer that major improvements in outcome after treatment of malignant melanoma of the oral cavity may not be carried out until more effective systemic therapy becomes available.
Servicio de Tumores de Cabeza, Cuello y Piel, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Av. Guauhtémoc 330, Col. Doctores, 06725 México, D.F., Mexico. resendizjaime@aol.com
Jaime Alonso
JA
Reséndiz-Colosia
Alma Gabriela
AG
Valenzuela-Flores
Francisco José
FJ
Gallegos-Hernández
Rutilio
R
Flores-Díaz
Sinhué
S
Barroso-Bravo
Sergio Arturo
SA
Rodríguez-Cuevas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000601:surgery*; D008800:Mexico; D008875:Middle Aged; D009061:Mouth Mucosa; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies