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What is Mucosal Melanoma?

Mucosal melanoma is a type of cancer that develops from the melanocytes that are present in the lining of the mucosal surfaces within the body, such as the sinuses, nasal passages, oral cavity, anus and vagina. Mucosal melanoma is extremely rare, making up only one percent of melanoma cases.

About 50 percent of mucosal melanoma cases start in the head and neck. Mucosal melanoma can manifest in several different ways within the head and neck region. It can develop as a lip and oral cancer, oropharyngeal cancer, or a paranasal sinus and nasal cavity cancer.

Symptoms of Mucosal Melanoma

Symptoms of mucosal melanoma of the head and neck may be:

  • Nose bleeds
  • Bleeding lump
  • Ulcers
  • Loss of sense of smell
  • Nasal obstruction
  • A discolored area in the mouth
  • Dentures that do not fit properly
Symptoms of mucosal melanoma of the anus include:
  • Bleeding in the area
  • Diarrhea
  • Constipation
  • Pain during a bowel movement
  • Hemorrhoids that won’t heal
  • A mass that is present
Symptoms of mucosal melanoma of the vagina include:
  • Discoloration of the vulva
  • Bleeding
  • Itching
  • Pain during intercourse
  • Discharge
  • A mass that is present

Risks and Prevention for Mucosal Melanoma

There are very few identified risk factors for mucosal melanoma. Mucosal melanoma, unlike melanoma skin cancer, is not linked to ultraviolet (UV) light exposure. Possible risk factors may differ according to the area where the disease is present.

Risk factors for mucosal melanoma within the head and neck include:

  • Poor fitting dentures
  • Smoking
  • Exposure to carcinogens in the environmen
Possible risk factors for mucosal melanoma within the anus include:
  • Human immunodeficiency virus (HIV)
Possible risk factors for mucosal melanoma within the vagina include:
  • Genetic predisposition
  • Viruses
  • Exposure to certain chemicals
  • Chronic inflammatory disease

Mucosal Melanoma Diagnosis

Mucosal melanoma is challenging to diagnose in part because of its rare occurrence and is often discovered in more advanced stages when symptoms begin to appear. Diagnosis for mucosal melanoma may involve a biopsy of the affected tissue. It is important to have regular medical check ups, because the earlier mucosal melanoma is diagnosed, the better.

At Penn Medicine, we use the American Joint Committee on Cancer — Tumor, Node, and Metastasis (AJCC-TNM) classification to stage mucosal melanoma:

  • T3: Mucosal disease
  • T4A: Moderately advanced disease—tumor is found in the cartilage, deep soft tissue, or overlying skin.
  • T4B: Very advanced disease—tumor has metastasized to other areas of the body.

Mucosal Melanoma Treatment

Treatment of mucosal melanoma is multidisciplinary and may include surgery, radiation therapy, chemotherapy and immunotherapy.

Primary treatment is usually surgery to remove the tumor or area where the cancer cells have developed. To help prevent the cancer from returning, your doctor may recommend radiation therapy and/or chemotherapy after surgery has been performed.