Although melanoma is classically thought of as a cutaneous malignancy, it can also arise from the mucosal epithelium of the respiratory, alimentary, and genitourinary systems. While cutaneous melanoma is well studied, the literature on mucosal melanoma is limited. This synopsis focuses specifically on melanoma of the oral cavity.

Melanoma is a rare malignancy of the oral cavity. It accounts for around 0.5% of all melanomas. Black individuals and individuals of Japanese descent are affected more often. There is a 2:1 male predilection, and most occur in the sixth decade of life or later.

Oral melanoma can present as a painless, bleeding mass or ulcer of the hard palate or maxillary gingiva, but about 60% of cases are asymptomatic and identified incidentally during a dental examination. It tends to be diagnosed when advanced, and only approximately one-third of patients give a history of a pre-existing pigmented lesion, either nevus or mucosal melanosis. The risk factors for oral melanoma are not well studied. Smoking, irritation from dentures, and alcohol use have been proposed but not confirmed as risk factors. Only around 10%-38% of patients survive 5 years or more.

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