Oral Malignant Melanoma: What Challenges do the team face due to the rarity of the disease?

Aims and Objectives
Literature states that oral melanomas account for 1.2 out of every 100 million malignancies diagnosed worldwide. This case report aims to discuss a patient who presented with an oral lump which following biopsy confirmed oral malignant melanoma. It explores the management options and considerations for this unusual oral malignancy.
History
History of asymptomatic lump upper right quadrant. Medically, the patient had several co- morbidities including a history of prostate cancer in 2014, COPD, chronic kidney disease with dialysis. He was an ex-smoker.
Investigations and Results
Clinical examination showed a black pigmented patch of the upper right maxilla. Biopsies confirmed malignant melanoma. The patient had MRI and CT investigations which confirmed no distant metastases or nodal involvement.
Discussion and Outcome
The patient was discussed initially at the head and neck MDT, however as the skin MDT could provide input on treatment for melanomas and their behaviour, a further MDT was conducted. It was jointly agreed for palliative radiotherapy to balance treatment of disease and the patient’s quality of life.
Conclusion
Oral melanomas are rare yet locally aggressive. It is important to consider a holistic approach for the patient, and if a lesion is rare, to consider which other teams may have experience in treatment that can aid any oral management.