Mucosal melanomas of the head and neck.

Mucosal melanoma is a rare tumor in the head and neck region. The presence of a pigmented lesion in the mucous membranes should raise the suspicion of malignant melanoma. It may at times be difficult for the pathologist to arrive at the diagnosis of malignant melanoma. It is mandatory, therefore, that the clinician provide the pathologist with a representative fresh biopsy specimen. One of the most intriguing features of this unusual tumor is the unpredictability of its clinical course. In some cases it is explosive, characterized by rapid, wide-spread dissemination. At other times, long dormant periods of more than 10 years' duration may be followed by recurrence with a fatal outcome. Radical surgery is the preferred treatment. Postoperative radiotherapy is applied when doubt exists as to the radicality of the surgical procedure. Treatment of recurrences, both local/regional, and distant, can be of great value to the patient. Therefore, otolaryngologists should be acquainted with the many local and systemic treatment modalities which have recently become available for recurrent melanoma. The ultimate prognosis is poor.