Review Article

Melanomas of Noncutaneous Origin: Diagnosis, Treatment, and Outcomes

Lisa A. Kottschade, APRN, MSN, CNP

Department of Medical Oncology, Mayo Clinic, College of Medicine, Rochester, Minnesota

Author’s disclosures of conflicts of interest are found at the end of this article.

Lisa A. Kottschade, APRN, MSN, CNP, Mayo Clinic, Department of Oncology, 200 First Street SW, Rochester, MN 55905. E-mail: kottschade.lisa@mayo.edu


J Adv Pract Oncol 2018;9(suppl 1):47–56 | https://doi.org/10.6004/jadpro.2018.9.7.14 | © 2018 Harborside™


  

ABSTRACT

Abstract

The most common presentation of melanoma is that of a primary skin lesion; however, there is a unique subset of patients who will present with rare and unique clinical circumstances requiring acute attention with respect to diagnostic and therapeutic interventions. Melanomas of mucosal origin are often mistaken for other medical conditions, thereby leading to a delayed and therefore more advanced disease at the time of diagnosis. Uveal (ocular) melanomas are difficult to diagnose and have a unique hematogenous spread, with the first site of disease outside the eye, usually presenting in the liver. As the biologic basis of these types of melanoma appears to be significantly different than that of melanomas of cutaneous origin, as well as the relative rarity, treatment is often difficult and extrapolated from case reports and small-cohort clinical trials. Herein this manuscript will discuss the typical presentation, workup, and surgical and medical management of disseminated disease for patients diagnosed with mucosal melanomas of the head and neck, gastrointestinal, and vulvar/vaginal regions, as well as melanomas of uveal origin.




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