American Journal of Applied Sciences 6 (8): 1467-1472, 2009
ISSN 1546-9239
© 2009 Science Publications
Corresponding Author: Maryam Assadat Hashemi Pour, Department of Oral Medicine, Faculty of Dentistry, Shafa St. Kerman, Iran.
Member of Kerman Dental and Oral Medicine Research Center. Tel: 0983412231196/09132996183
1467
Malignant Mucosal Melanoma of the Head and Neck Diagnosed in an
Iranian Population over an 11-Year Period
Maryam Assadat Hashemi Pour, M. Rad, M.R. Zarei and G. Chamani
Department of Oral Medicine, Faculty of Dentistry,
Kerman University of Medical Sciences, Kerman, Iran
Member of Kerman Dental and Oral Medicine Research Center
Abstract: Problem statement: Mucosal Melanoma of the Head and Neck (MMHN) is a rare lethal
disease. This malignancy accounts for half of all mucosal melanomas, occurring mainly in the nasal
cavity, oral cavity and pharynx. They appear with equal gender distribution and with a peak incidence
in the age range 60-80 years. The aim of this study was to investigate incidence, sex, age and site
distribution of MMHN in the Kerman province during the time period from March 1991-2002.
Approach: Documents and records of 52 patients with MMHN diagnosed from March 1991-2002
were reviewed. The patients were analyzed according to gender, age and location of the tumor. Data
included in the present retrospective study were analyzed by SPSS13.5 statistical software, t-test and
chi-square. Results: During this time period, 52 cases (25 men and 27 women) of MMHN were
diagnosed. The age range was 7-84 years. The nasal cavity (55.8%) was the most affected site. The
palate and upper gingiva was the most common site in the oral cavity (8 patients, 88.8%). Survivals 5
years in MMHN patients were 27% and patients with mucosal melanoma of oral cavity have an 11%, 5
year survival rate. Conclusion: Comparison between the findings of this study with the results
obtained by other investigators showed a relative consistency.
Key words: Melanoma, malignant, head, neck
INTRODUCTION
Malignant melanoma incidence has risen markedly
over the past 30-40 years and continues to increase in
the United States, Canada, Australia, Asia and
Europe
[1-4]
.
Malignant Melanoma (MM) that does not originate
in the skin is a very rare tumor and is considered as one
of the most deadly of all human neoplasms
[5-8]
. Primary
mucosal melanomas of the upper aero-digestive tract
are uncommon and represent only 1.7-3% of all
primary melanomas
[1-4,9,10]
. The first case in the English
literature were reported in 1885 by Lincoln: Since that
time, over 1000 patients have been reviewed
[11]
. The
most frequent localizations are the nasal fossae, the
paranasal sinuses and the oral cavity where melanomas
most often arise from the palate and alveolar ridge,
buccal mucosa, lips, tongue and floor of mouth.
MMHN comprise about 1-8% of all malignant
melanomas
[1-4,9,10]
and comprise> 20% of all
melanomas of the head and neck melanomas
[4,10,12]
.
In searching the English literatures of the last 15
years for head and neck melanomas, we found very few
articles that describe case series limited to mucosa of
the head and neck region. Hormia and Vuori reported
that mucosal melanomas represent only 0.009% of all
malignant tumors is Finland
[13]
. Others reported that
only 6.3% of all melanomas in the head and neck
region are of mucosal original. According to Moore and
Martin mucosal melanomas in the nasal and oral cavity
account for only about 1.7% of all melanomas
[14]
.
Another study demonstrated that oral melanomas are
very rare, accounting for only 1.6% of 7500 melanomas
reported
[15]
. Racial, cultural or geographic factors may
predispose subjects to the this malignancy
[16,17]
. The
mean age at diagnosis of patients with oral melanoma is
55 years (range, 40-70 years)
[18-21]
, although in some
researches this malignancy appeared with a peak
incidence in the age range 60-80 years
[4,19-21]
. A recent
literature review showed the description of 14 cases of
mucosal melanoma of the head and neck in a total of
approximately 1000 cases of head and neck
melanomas
[22]
. Of 14 new cases reported, only one case
occurred in the oral mucosa. A high predilection was
found for the palate and the maxillary gingiva with 77%
of the cases reported in those sites
[15,19-22]
. Interestingly,