Jasper Polly, Jungbauer W Nicholas, Poupore Nicolas S, Nguyen Shaun A, Howell Jim, Neville Brad W, Day Terry A
Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States.
Carolinas Center for Oral and Facial Surgery, Greenville, SC, United States.
Turk Arch Otorhinolaryngol. 2022 Sep;60(3):161-169. doi: 10.4274/tao.2022.2022-7-5. Epub 2022 Nov 15.
Malignant mucosal melanomas of the head and neck comprise a very small portion of all melanomas, particularly in the oral cavity. These lesions are associated with high rates of local recurrence, distant metastasis, and a very poor 5-year survival rate; however, the clinical outcomes of mucosal melanoma in situ of the oral cavity are unclear. Therefore, we present a case report of mucosal melanoma in situ and a systematic review of the literature to shed light on this rare but important disease.
PubMed, Scopus, and CINAHL were searched per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were only considered for inclusion if they described oral cavity melanoma in situ and documented specific data pertaining to treatment including modality, lesion size, or outcomes.
A total of 28 reported cases from the literature fulfilled the inclusion criteria, as well as one case from our own institution. Men comprised the majority (64.3%) of the cases, and the average age at presentation was 57.4 years. The hard palate was the most common location, and most cases were treated with surgical excision. Eight had no evidence of disease after a minimum of six months of follow-up, one reported spread to the cervical lymph nodes, and only one reported progression with distant metastasis.
Oral mucosal melanoma in situ is a rare entity and most commonly treated with surgical excision. High rates of recurrence necessitate long term follow-up. Further studies may be useful to determine whether adjuvant therapy may play a role in reducing recurrence.
头颈部恶性黏膜黑色素瘤在所有黑色素瘤中所占比例极小，在口腔中尤为如此。这些病变与局部复发、远处转移的高发生率以及极低的5年生存率相关；然而，口腔原位黏膜黑色素瘤的临床结局尚不清楚。因此，我们报告一例口腔原位黏膜黑色素瘤病例，并对文献进行系统综述，以阐明这种罕见但重要的疾病。
按照系统评价和Meta分析的首选报告项目指南，检索了PubMed、Scopus和CINAHL数据库。仅纳入描述口腔原位黑色素瘤并记录了与治疗相关的具体数据（包括治疗方式、病变大小或结局）的研究。
文献中共有28例报告病例符合纳入标准，我们自己机构也有1例。病例中男性占大多数（64.3%），就诊时的平均年龄为57.4岁。硬腭是最常见的部位，大多数病例采用手术切除治疗。8例在至少6个月的随访后无疾病证据，1例报告有颈部淋巴结转移，只有1例报告有远处转移进展。
口腔原位黏膜黑色素瘤是一种罕见的疾病，最常采用手术切除治疗。高复发率需要长期随访。进一步的研究可能有助于确定辅助治疗是否在降低复发率方面发挥作用。
