Mucosal Melanoma

This is an aggressive and rare form of cancer that begins to develop in the mucous membrane (mucosa). It is called mucosal melanoma, and it affects the soft tissue that lines organs and other parts throughout the body. Most of the time, this type of cancer spreads until it is diagnosed.

In other words, mucosal melanoma is a type of melanoma that starts to develop in the mucosa. While it may appear anywhere in the body, it often affects the following areas. For example:

The vagina and vulva
The anus and rectum
The head and neck region (including the nose, lips, and mouth)

Usually, doctors are able to remove the tumor with surgery, but in most cases, treatment for mucosal melanoma requires a healthcare team and a combination of treatments.

How Common is Mucosal Melanoma?

This type of melanoma occurs quite rarely. According to the American Cancer Society, it accounts for approximately 1% of all melanoma cases.

What Are The Symptoms of Mucosal Melanoma?

This type of cancer is often found in advanced stages because it causes symptoms that you are not likely to monitor for changes (such as the inside of the nose or skin around the anus). Moreover, the following symptoms are very similar to those of other health conditions. Check some symptoms below:

Head and Neck Symptoms

Commonly, about 30% to 50% of people who develop mucosal melanoma experience the following symptoms. For example:

Oral Mucosa Melanoma

Mouth sores that do not heal
A lump on the tongue
Bleeding
Dentures that do not fit well
Mouth pain

Sinonasal Mucosal Melanoma

The following symptoms occur when the tumor develops in the nose and sinuses. Examples include:

Frequent nosebleeds (epistaxis)
Runny nose
Facial pain
Feeling like something is stuck in the nose (also known as nasal obstruction)

Laryngeal/pharyngeal Mucosal Melanoma

This is the rarest form of mucosal melanoma, and it impacts your throat. Usually, it causes the following symptoms. These include:

Pharyngitis (sore throat)
Dysphagia (swallowing problems)
Hoarseness
A mass of lumps on the outside of the neck

Anus and Rectum

Approximately 17% to 24% of all diagnosed mucosal melanomas affect the anus and/or rectum. This form of cancer often causes the following symptoms. For example:

Constipation
Itchiness
Bleeding from the rectum or anus
A lump or mass in the anus or rectum
Pain

Vulva and Vagina

This form of mucosal melanoma accounts for about 18% of all cases, and it often causes the following symptoms. For example:

Discharge from the vagina (including bloody discharge)
Itching in the vagina or vulva that does not disappear even with treatment
A growth or lump in the vagina or vulva
Pain
Abnormal vaginal bleeding that occurs between periods or after menopause

Causes

Nowadays, experts do not know the exact cause of mucosal melanoma. However, all melanomas are tumors that develop from melanocytes (specific cells that produce melanin pigments). This pigment determines the color of the hair, eyes, and skin. Melanin also protects the skin and eyes from sun damage.

Furthermore, some researchers have discovered two genetic mutations (changes) present in people with mucosal melanoma. These include mutations in the KIT and BRAF genes, which are somatic mutations (they appear during a lifetime).

KIT gene – This gene controls how fast certain cells grow (including melanocytes). It also produces a specific protein give specific instructions to the cells. While it appears in 7% to 17% of people with mucosal melanoma, KIT gene mutations appear in approximately 30% of people with mucosal melanoma that affects the vagina and vulva.
BRAF gene – This gene is responsible for instructions that tell cells how fast to multiply and divide. When it mutates, the cells receive different instructions that cause them to multiply and divide in an abnormal manner, which allows the development of tumors. A mutated BRAF gene is present in about 3% to 15% of people with mucosal melanoma.

Risk Factors

While anyone may develop mucosal melanoma, the following factors may increase the risk even more. Check some of them below:

Age – This type of melanoma mostly affects older adults (over 70 years old).
Gender – Females are more likely to develop mucosal melanoma compared to males.
Smoking – Usually, smoking is linked to neck and head mucosal melanomas. Furthermore, prolonged exposure to chemicals may also increase the risk.
Viral infections – People who have HPV (human papillomavirus) are more prone to mucosal melanoma.
Genetic factors
Existing health conditions – People with a medical history of chronic (long-term) inflammation and melanosis (pigmented lesions) are at higher risk of developing mucosal melanoma.

What Are The Possible Complications of Mucosal Melanoma?

Most people with this type of melanoma also experience complications, because it spreads before it is diagnosed. Check some complications below:

Frequent nosebleeds
Facial deformation
Problems with swallowing and breathing
Pelvic pain
Hematuria (blood in the urine)

This document does not contain a complete list of mucosal melanoma complications. In any case, you can consult with your physicians about measures to reduce the risk or prevent them, although it is almost impossible to prevent them.

Diagnosis

When doctors suspect mucosal melanoma, the diagnosis starts with a physical examination and questions about your medical history and symptoms. However, to confirm or rule out mucosal melanoma, doctors may perform the following tests. These include:

CT (computerized tomography) scans
MRI (magnetic resonance imaging) scans
Biopsy – This test involves the removal of a small sample of tumor to examine it under a microscope. Doctors often check it for cancerous cells.
Genetic tests – This test involves a blood sample to check for the abnormal genes that can be present in people with mucosal melanoma.

Furthermore, once you are diagnosed with this type of melanoma, physicians may perform additional imaging tests to determine the extent (stage) of the cancer. It often helps make the best treatment plan for you.

Treatment

Most people with mucosal melanoma require a healthcare team that includes specialists in surgical oncology, radiation oncology, and medical oncology. Check some treatments below:

Surgery – This is the primary treatment for people who develop this form of melanoma. It is used to remove the tumor.
Radiation therapy – This is another cancer treatment used to destroy cancerous cells that may remain even after a successful surgery.

Frequently Asked Questions

Does sun damage cause mucosal melanoma?

No, it does not cause this type of melanoma because the places where the tumor develops are not exposed to sunlight.

How serious is mucosal melanoma?

This is an aggressive and serious type of melanoma that mostly spreads before it is diagnosed. That’s why the prognosis is usually poor for people with mucosal melanoma.

What is the best treatment for mucosal melanoma?

The primary and most effective treatment for mucosal melanoma is surgical resection. Sometimes, physicians may also recommend radiation therapy. If you have additional questions, ask your healthcare professional.