What Is Mucosal Melanoma?

Melanoma, no matter where on or in the body it occurs, starts from pigment cells called melanocytes. Like the melanocytes found in the skin, mucosal melanocytes can become cancerous and mutate. These changes result in the development of a type of melanoma called mucosal melanoma.

While most melanoma appears on the skin, mucosal melanoma does not. Instead, it occurs in the mucous membranes, or moist surfaces, of areas inside your body. These mucous membranes line areas such as the sinuses, nasal passages, oral cavity, vagina, and anus.

Mucosal melanoma accounts for approximately 1.4% of all melanoma. Approximately 50% of mucosal melanomas begin in the head and neck. Most of the remaining 50% begin in the anus or rectal region and the female genitals, and a small percentage develop in the esophagus, gallbladder, bowel, conjunctiva, and the urethra. It tends to develop later in life, with a median age of diagnosis of 70.

While melanomas that appear on the skin and mucosal surfaces all start from melanocytes, cutaneous (skin) melanoma and mucosal melanoma differ significantly in their behavior and their basic biology. The risk of developing cutaneous melanoma is linked with a history of sun exposure, particularly during childhood, but this risk factor is not established for mucosal melanoma. At this time, no risk factors, such as sun exposure or family history, have been established for this disease.

As with most cases of melanoma, complete removal of the mucosal melanoma through surgery provides the highest likelihood of a good prognosis. The possibility of completely resecting the disease is greatest when diagnosed early; however, unfortunately, such early diagnosis is difficult for several reasons. The tumors cause fairly general symptoms, and since this disease occurs in such a small population of people, often neither the patients nor physicians immediately suspect mucosal melanoma as the cause of their symptoms. Also, symptoms differ depending on where the mucosal melanoma develops, but can include bleeding, rectal discomfort, and the development of a rectal mass in cases of anorectal mucosal melanoma; vaginal bleeding, vaginal discharge, and the development of pigmented spots in cases of vulvovaginal melanoma; or the development of recurrent nose bleeding in sinonasal mucosal melanoma.

Despite the significant advances that have been made in the understanding of mucosal melanoma, this disease remains a challenging one to treat. While the new immunotherapy and targeted therapy treatments have greatly improved outcomes in patients with cutaneous melanoma and can help some patients with advanced mucosal melanoma, overall, they do not work as well in mucosal melanoma. To develop more successful treatments, we must support combined efforts between the patients dealing with this disease, the doctors caring for them, and the laboratory and clinical researchers working to develop new treatments for mucosal melanoma. It is through this kind of cooperation that we can increase education and awareness of this rare disease and ultimately identify new, more effective, and potentially curative treatments.

Mucosal Melanoma Symptoms

Depending on the site involved, the signs and symptoms of mucosal melanoma vary and may include:

  • Nose bleeds, breathing difficulty, or pain inside the nose
  • Pigmented lesions/masses inside the mouth, cheeks, or lips
  • Pain or bleeding from the anus, or a protruding mass
  • Vaginal bleeding, discharge, pain or itching
  • Difficulty or pain during swallowing or speaking
  • Blood in the urine or increased urinary frequency
  • Abdominal pain on the right side of the abdomen
  • Yellowed skin and whites of the eyes

Promptly see your healthcare provider if you experience any of the above symptoms.