Mucosal melanomas of the head and neck area are rare cancers and the present 12 year experience with 43 consecutive patients is larger than found in most reports. Probably the most frustrating and ominous trait of any melanoma is the almost total unpredictability of its clinical behavior. To illustrate this erratic quality, 2 cases are briefly presented. It is undoubtedly this curious biologic behavior of melanoma which accounts for the salvage of 1 more case in Stage 2 than in the more numerous Stage 1 cases. In most other forms of cancer (including skin melanomas), the 5 year cure rate for State 1 cases is at least double that for Stage 2. At the present time, surgery is the only known treatment of curative possibility for melanoma.