Oral mucosal melanoma: conservative treatment including laser surgery.
OBJECTIVE
To discuss the convenience of laser surgery as optimal treatment for melanoma of the oral mucosa.


METHODS
A retrospective evaluation of four patients with primary oral melanomas treated at a single Cancer Institution in Mexico City.


RESULTS
Two patients were treated with resection of the melanoma with CO2 laser together with extraction of the involved dental organs and curettage of the alveolar walls. These two cases had melanoma in situ with multiple isolated foci. The third patient had a lesion with vertical growth, who was submitted to partial maxillectomy along with selective dissection of bilateral neck levels I-V with a negative report and the fourth patient had a history of oral nodular melanoma and presented with lymph node metastasis. According to follow-up status, there was no distant metastasis in any of the patients reported here.


CONCLUSIONS
In our experience, conservative management with CO2 laser is adequate for melanomas of the oral mucosa with extraction of the dental organs and curettage of the alveoli to achieve complete surgical resection microscopically without sacrifice of the quality of life. Management of the neck is controversial. We recommend selective therapeutic resection of the neck only if it is found to be clinically positive. Elective dissection has not shown to have an impact in overall survival.
Luna-Ortiz
Kuauhyama
K
Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Av. San Fernando 22, Col. Sección XVI, 14080 Mexico, D.F., Mexico. kuauhyama@yahoo.com.mx
Campos-Ramos
Eunice
E
Pasche
Philippe
P
Mosqueda-Taylor
Adalberto
A
D000328:Adult; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa; D009062:Mouth Neoplasms / Q000601:surgery*; D012189:Retrospective Studies