Mucosal Malignant Melanomas Of The Head And Neck: With Special Reference to Cases having a Prolonged Clinical Course

Abstract

A histological re-examination and re-classification of primary mucosal tumours of the head and neck region, treated at Radiumhemmet and Karolinska sjukhuset during the period 1927–1970, revealed that 41 tumours were malignant melanomas. All these 41 tumours were located in the nasal cavity, paranasal sinuses and oral cavity and not a single case of primary mucosal malignant melanoma was found in other locations of the head and neck region. In the present study, the long-term prognosis has been analysed. The follow-up period was at least 5 years and ranged up to 48 years. It was found that mucosal malignant melanomas had a very poor prognosis with a five year survival rate of 17 per cent (7 of the total 41 cases) and a ten year survival rate of 7 per cent (3 of the total of 41 cases). The unpredictability of the clinical behaviour of this tumour type is elucidated by cases with a prolonged clinical course despite a primary relatively limited surgery, repeated local recurrences and regional lymph node metastases in an early stage of the disease. Thus, there is always a never-ceasing risk of death in the tumour disease when once a malignant melanoma has occurred. For this reason a meticulous and lifelong follow-up of tumour patients is stressed, and also the value of repeated surgery of local recurrences and regional lymph node metastases. ZUSAMMENFASSUNG Eine erneut aufgenommene histologische Untersuchung und Klassifikation von primären Schleimhauttumoren im Kopf- und Halsbereich, die in der Zeitspanne von 1927 bis 1970 in Radiumhemmet und Karolinska Sjuk-huset in Stockholm behandelt worden waren, erbrachte, dass 41 Tumoren maligne Melanome waren. Alle diese 41 Tumoren waren auf die Nasenhaupthöhle, die Nasen-nebenhöhlen und die Mundhöhle begrenzt. An andern Stellen des Kopf- und Halsbereichs wurde kein einziger Fall von primären malignen Schleimhautmelanomen gefunden.