Primary oral and sinonasal mucosal melanoma: Narrative review
Keywords:
melanoma, mucosal melanoma, oral melanoma, sinonasal melanomaAbstract
Primary sinonasal and oral mucosal melanomas (PSOMM) are aggressive and infrequent tumors that exhibit a biological behavior distinct from their cutaneous counterparts. They account for approximately 4% of all head and neck cancers and represent less than 0.5% of all melanomas. PSOMM are frequently diagnosed at advanced stages due to the difficulty patients have in recognizing early signs and symptoms. Recent studies have linked melanoma tumorigenesis to alterations in various tumor suppressor genes and oncogenes that affect key signaling pathways such as NRAS, KIT, BRAF, PTEN, and MITF, influencing cell proliferation, survival, and apoptosis. The identification of these alterations has enabled the development of targeted therapies, such as BRAF and KIT inhibitors (vemurafenib and sunitinib), currently applied in metastatic cutaneous melanoma; however, the overall response has been limited in mucosal melanomas of the head and neck, with five-year survival rates ranging between 15% and 30%. This narrative review aims to provide a comprehensive survey on the clinical, pathological, molecular, and therapeutic aspects of PSOMM. To achieve this, a narrative literature review was conducted using the PubMed and Google Scholar databases. Relevant articles published between 1990 and 2024 were included, selected based on their relevance to the clinical, pathological, molecular, and therapeutic aspects of PSOMM. The review consisted of a compilation of scientific information published worldwide. The following keywords were used in the search strategy: “mucosal melanoma,” “oral melanoma,” “sinonasal melanoma,” “immunohistochemistry,” and “targeted therapies.”
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