Oral mucosal melanoma: Conservative treatment including laser surgery

ABSTRACT

Objective: To discuss the convenience of laser surgery as optimal treatment for melanoma of the oral mucosa.Patients and methods: A retrospective evaluation of four patients with primary oral melanomas treated at a singleCancer Institution in Mexico City.Results: Two patients were treated with resection of the melanoma with CO2 laser together with extraction of theinvolved dental organs and curettage of the alveolar walls. These two cases had melanoma in situ with multipleisolated foci. The third patient had a lesion with vertical growth, who was submitted to partial maxillectomy alongwith selective dissection of bilateral neck levels I-V with a negative report and the fourth patient had a history oforal nodular melanoma and presented with lymph node metastasis. According to follow-up status, there was nodistant metastasis in any of the patients reported here.Conclusion: In our experience, conservative management with CO2 laser is adequate for melanomas of the oralmucosa with extraction of the dental organs and curettage of the alveoli to achieve complete surgical resectionmicroscopically without sacrifice of the quality of life. Management of the neck is controversial. We recommendselective therapeutic resection of the neck only if it is found to be clinically positive. Elective dissection has notshown to have an impact in overall survival (AU)

RESUMEN

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