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Int J Clin Exp Pathol 2012;5(8):739-753

Review Article
Primary mucosal melanomas: a comprehensive review

Marija Mihajlovic, Slobodan Vlajkovic, Predrag Jovanovic, Vladisav Stefanovic

Department of Clinical Research, Department of Anatomy, and Clinic of Ophthalmology, Bul. Zorana Djindjica 81, 18000 Nis, Serbia

Received August 3, 2012; Accepted September 4, 2012; Epub October 1, 2012; Published October 15, 2012

Abstract: Primary mucosal melanomas arise from melanocytes located in mucosal membranes lining respiratory, gastrointestinal and
urogenital tract. Although a majority of mucosal melanomas originate from the mucosa of the nasal cavity and accessory sinuses, oral cavity,
anorectum, vulva and vagina, they can arise in almost any part of mucosal membranes. Most of mucosal melanomas occur in occult sites,
which together with the lack of early and specific signs contribute to late diagnosis, and poor prognosis. Because of their rareness the
knowledge about their pathogenesis and risk factors is insufficient, and also there are not well established protocols for staging and treatment
of mucosal melanomas. Surgery is the mainstay of treatment, with trends toward more conservative treatment since radical surgery did not
show an advantage for survival. Radiotherapy can provide better local control in some locations, but did not show improvement in survival.
There is no effective systemic therapy for these aggressive tumors. Compared with cutaneous and ocular melanoma, mucosal melanomas
have lowest percent of five-year survival. Recently revealed molecular changes underlying mucosal melanomas offer new hope for
development of more effective systemic therapy for mucosal melanomas. Herein we presented a comprehensive review of various locations of
primary melanoma along mucosal membranes, their epidemiological and clinical features, and treatment options. We also gave a short
comparison of some characteristics of cutaneous and mucosal melanomas.

Keywords: Mucosal melanoma, gastrointestinal, respiratory, urogenital

Address all correspondence to:
Dr. Vladisav Stefanovic, Faculty of Medicine, Bul. Zorana Djindjica 81, 18000 Nis, Serbia. Tel: 381-18-4670-029; Fax: 381-18- 4238-770; E-mail: