Oral Melanoma
- Medicine Community & Research
- Oct 29, 2024
- 3 min read
By Sanjana Malkareddy
By Natalia Blauth from Unsplash
What is it?
Making up 1% of all melanomas, oral melanomas are a rare and aggressive cancer caused by malignant melanocyte changes. Melanocytes are cells that produce melanin, a pigment responsible for skin tone. Although these cells are primarily found in the epidermis (top layer of skin), they can also be found in the mucosal membranes of the mouth and other body parts.
Causes
The exact causes of oral melanomas remain unknown. Oral melanomas are unrelated to sun exposure as opposed to other skin melanomas. Although, possible causes include:
denture irritation
alcohol abuse
tobacco smoking
genetic mutations
However, specialists haven’t found a direct connection between the listed causes and the occurrence of oral melanomas.
Symptoms
Symptoms of oral melanomas can include those of other melanomas. In oral melanomas, the cancer can appear as a brown or black spot that can be flat or raised. The color variation on those spots can differ, with some being gray, red, and purple, while others have depigmentation. The spots can be asymmetrical and have smaller spots, satellite tumors, surrounding them. When receiving a diagnosis, some people might be asymptomatic, while others may experience swelling, redness, and dental pain, which are the symptoms of tumor growth. Symptoms of later stages of this cancer include redness of the mucosa (erythema) and ulceration.
Diagnosis
Oral melanomas can be difficult to diagnose as they can be in areas hard to see and are typically overlooked in their early stages. They also present various characteristics that may indicate similar conditions, such as melanoma macule, Addison’s disease, and post-inflammatory pigmentation. Diagnosing this type of cancer includes the ABCD scoring method to distinguish malignant oral melanomas from benign lesions. The method evaluates certain characteristics of the tumor such as asymmetry, irregularity of the border, color imbalance, and diameter greater than 0.6 mm. A tissue biopsy will be performed for an accurate diagnosis and the use of computerized tomography (CT) and magnetic resonance imaging (MRI) may also be conducted to check for metastasis.
Treatment
Surgery, the most effective treatment option, removes the tumor and some surrounding tissue to ensure no cancer cells are left. Other treatment options include radiation therapy which uses high-frequency waves to kill remaining cancer cells and decrease the chances of the cancer metastasizing. Because oral melanomas are rare and there is a lack of evidence supporting certain treatments, options like chemotherapy and immunotherapy are uncommon. However, they may be recommended to prevent the cancer from metastasizing.
Outlooks
As oral melanomas are generally overlooked and symptoms become present as the disease progresses, the outlook is generally poor. Oral mucosal melanomas have a 5-year survival rate of approximately 15-30%. However, the outlook varies on a case-by-case basis, as factors such as your response to treatment and the stage at which your cancer was diagnosed can greatly influence the prognosis.
Risk Factors
Risk factors for oral melanomas aren’t widely known, although some plausible factors include:
Age: The peak diagnosis is between the ages 65-79 years.
Sex: Females are at a greater risk of developing mucosal melanomas, whereas males are more likely to develop melanoma of the lip. Regardless, males and females are at equal risk for developing oral malignant melanoma.
Race: Oral melanomas are more likely to occur in black individuals and individuals from Japan and South Asia.
Human Papillomavirus (HPV): There may be a relation between this infection and oral melanomas, however, this isn’t well-researched.
Genetic mutations: Certain mutations can increase your probability of developing an oral melanoma.
Citations
MediLexicon International. (n.d.). Oral melanoma: Causes. symptoms, treatment, and more. Medical News Today. https://www.medicalnewstoday.com/articles/oral-melanoma
Srakocic, S. (2024, February 14). Oral melanoma: Causes, symptoms, and treatment. Healthline. https://www.healthline.com/health/cancer/oral-melanoma
