Malignant melanoma of the oral cavity.

Mucosal malignant melanomas of the oral cavity are rare and the present series comprising 23 patients is one of the largest ever published. The poor prognosis of these tumors appears from the fact that only two of the 23 patients could be presumed to have been treated sucessfully. The survival time of the 21 patients who died during the follow-up period was short in all but one patient, surviving 35 years after the first symptom of the tumor despite regional lymph node metastases in an early stage of the disease and repeated local recurrences. This indicates the importance of a regular lifelong follow-up and surgical activity concerning local recurrences and regional lymph node metastases. The poor prognosis may be explained by the patients' delay in seeking medical advice, which is stressed by the deep and massive infiltration of the extensive primary lesions as well as by the fact that metastases already were demonstrable in most patients at the first examination. A necessary condition for radical surgical therapy, and therefore an improvement in the very bad prognosis of oral malignant melanomas, is an earlier diagnosis than in the present series. As oral malignant melanomas almost exclusively appear in the palate and superior alveolar process, particular attention must be paid to lumps, ulcerations and pigmented spots occurring in this region.