Background: Oral mucosal melanomas (OMM) represent a rare subset of oral malignancies. They pose a particular interest to the head and neck surgeon given their propensity of early neck metastasis and aggressive disease nature.
Methods: To conduct a systematic review of primary mucosal melanomas of the oral cavity. To assess the reported incidence, presentation, management strategies and outcomes.
Results: Following PRISMA guidelines a systematic review was conducted. A total of 22 papers were eligible for inclusion, including 1,782 patients. The majority of OMMs were located on the hard palate (46%), followed by the gingiva (34%). There was a slight male preponderance, 51% to 49% females. Most patients presented with advanced disease, 68% with stage 3 and stage 4 disease. Surgical excision formed the cornerstone of treatment with 77% undergoing radical resection of the primary site and 52.5% of patients underwent neck dissection. Radiotherapy was administered to 538 patients (42%), and chemotherapy in 316 patients. The average 5-year survival was 23%.
Conclusion: OMMs are a distinct entity compared to MM of other sites. Their management remains contentious and, although rare, they represent an area that necessitates ongoing research.