Mucosal melanomas in the elderly: challenging cases and review of the literature

Clin Interv Aging. 2014 Jun 12:9:929-37. doi: 10.2147/CIA.S64361. eCollection 2014.

Abstract

Melanomas are malignant tumors that originate from melanocytes. They are most frequently localized in the skin, but 5% of all melanomas interest also extracutaneous sites as mucosal surfaces, parenchymatous organs, the retroperitoneum area, and the ocular ball. The purpose of this study was to investigate the epidemiologic and morphologic data of mucosal melanomas diagnosed at Emergency City Hospital (Timisoara, Romania) during a period of 12 years. The study included 17 cases of extracutaneous, extraocular melanomas, with 16 primary melanomas and one secondary melanoma. All our patients were older than 53 years and were mostly men. Most of the patients presented with localized disease; only one case had regional lymph node metastases, and another one had systemic metastases at the time of diagnosis. Regarding localization, nine of 16 melanomas were in the head and neck region, six were diagnosed in the gastrointestinal and urogenital tracts (three cases each), and one case had a rare localization (retroperitoneum). The most common histologic type was represented by epithelioid cells, and the majority of the tumors were achromic. Mucosal melanoma is a tumor associated with aging, all our patients being older than 53 years. Because of unspecific symptoms and low incidence, the diagnosis is often delayed and requires teamwork among the clinician, pathologist, radiologist, and oncologist. Different genetic fingerprints impose a correct diagnosis to offer the patient the best novel, personalized therapy.

Keywords: immunohistochemistry; kit gene mutations; melanocytes; molecular classification; mucosal melanoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intestinal Mucosa / pathology
  • Intestinal Neoplasms / diagnosis
  • Intestinal Neoplasms / pathology
  • Intestinal Neoplasms / therapy
  • Laryngeal Mucosa / pathology
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / therapy
  • Male
  • Melanoma / diagnosis
  • Melanoma / pathology
  • Melanoma / therapy*
  • Middle Aged
  • Mouth Mucosa / pathology
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / therapy
  • Mucous Membrane* / pathology
  • Nasal Mucosa / pathology
  • Nose Neoplasms / diagnosis
  • Nose Neoplasms / pathology
  • Nose Neoplasms / therapy
  • Retrospective Studies