구강 악성 흑색종의 임상적 연구

A Clinical study of oral malignant Melanoma

Malignant melanoma is not a frequent disease, but the worldwide incidence of melanoma is reported as increasing. It can be divide into skin lesion and mucosal lesion. The mucosal melanoma is known to hve much more poor prognosis than the skin lesion, because of delayed visitation to the hospital, much easier invasion pattern, and insufficient surgical margin, etc. Oral malignant melanoma are rarely reported in Caucasians, but in our country, malignant melanoma of the oral cavity is much more common than that of the skin in the head and neck area. 20 patient were diagnosed as primary malignant melanoma of oral cavity at the department of dentistry & oral oncology in Korea Cancer Center Hospital(KCCH), during 13 years from 1983 to 1995. The male patients were 14 of them. And 14 patients of them had had the habit of cigarette smoking. The age range of patients were 47 to 70, with an average age of 59.8 years. The primary sites of cancer were all in the maxilla; chiefly in the gingiva and hard palate. The chief complaints of these patients wee black pigmentation of oral mucosa, swelling of palate and/or gingiva, and infrequently intermittent bleeding. Pain was not a prominent feature. 12 of 20 patients were treated in our department. Other 8 patients refused our proposal. Our treatment modalities to treat oral melanoma were chiefly radical resection with neoadjuvant or adjuvant chemotherpy. 10 of them are still alive, and 2 of them were not known. This suggests that the prognosis of oral malignant melanoma is not so poor as known previously if adequate therapy is taken.