Malignant melanoma in the head and neck region - A systematic review.

Dr. Karthik  Shunmugavelu; Dr. Evangeline Cynthia  Dhinakaran; Dr. Rufus Ranjitsingh  Edwin

doi:10.51168/sjhrafrica.v6i12.2660

Authors

Dr. Karthik Shunmugavelu Assistant Professor Department of Dentistry PSP medical college hospital and research institute Tambaram Kanchipuram main road Oragadam Panruti Kanchipuram district Tamilnadu 631604.
Dr. Evangeline Cynthia Dhinakaran Assistant Professor Department of Pathology, Sree Balaji Medical College and Hospital, Chrompet, Chennai-600044, India.
Dr. Rufus Ranjitsingh Edwin MBBS, MS General Surgery, Assistant professor, Vels medical college and hospital, Tamilnadu, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2660

Keywords:

Head and Neck Melanoma, Mucosal Melanoma, Cutaneous Malignant Melanoma, Radiotherapy and Surgery, Nicotinamide N-Methyltransferase (NNMT)

Abstract

Background

Malignant melanoma of the head and neck (HNM) is a rare but aggressive neoplasm with significant heterogeneity in clinical presentation, biological behavior, and outcomes. This systematic review evaluated the clinical, prognostic, and therapeutic aspects of cutaneous and mucosal HNM, with emphasis on survival outcomes, treatment strategies, and molecular markers such as nicotinamide N-methyltransferase (NNMT).

Methods

A systematic literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar for studies published from 1977 to March 2024. Inclusion criteria comprised original clinical studies and systematic reviews evaluating HNM patients, including tumor subtypes, survival, treatment modalities (surgery, radiotherapy, or both), and molecular characteristics. Extracted data included demographic distribution, anatomical subsite prevalence, pathological staging, treatment outcomes, and prognostic factors.

Results

Cutaneous HNM was more common in elderly males and frequently involved sun-exposed facial regions, with poorer overall survival than melanomas at other anatomical sites. Mucosal melanoma of the head and neck (MMHN), especially sinonasal and oral variants, demonstrated high local recurrence and distant metastasis rates with limited survival improvement. Combined surgery and radiotherapy (SRT) improved local control and moderately enhanced survival compared to surgery or radiotherapy alone. NNMT overexpression was associated with adverse clinical outcomes across multiple HNM subtypes, suggesting its value as a prognostic biomarker and therapeutic target.

Conclusion

Head and neck melanomas are biologically distinct malignancies with aggressive behavior and challenging management outcomes. Multimodal treatment approaches and integration of molecular biomarkers such as NNMT may improve prognostication and individualized therapy.

Need for future research

Large-scale prospective studies are required to refine staging systems, validate emerging biomarkers, and evaluate targeted therapeutic strategies for improved management of HNM.

Author Biographies

Dr. Karthik Shunmugavelu, Assistant Professor Department of Dentistry PSP medical college hospital and research institute Tambaram Kanchipuram main road Oragadam Panruti Kanchipuram district Tamilnadu 631604.

is an Assistant Professor in the Department of Dentistry at PSP Medical College Hospital and Research Institute, Tamil Nadu, India. He specializes in Oral and Maxillofacial Pathology and holds multiple international academic affiliations and professional memberships in pathology and dental education.

Dr. Evangeline Cynthia Dhinakaran, Assistant Professor Department of Pathology, Sree Balaji Medical College and Hospital, Chrompet, Chennai-600044, India.

is an Assistant Professor in the Department of Pathology at Sree Balaji Medical College and Hospital, Chennai, India. Her academic interests include diagnostic pathology and oncopathology.

Dr. Rufus Ranjitsingh Edwin, MBBS, MS General Surgery, Assistant professor, Vels medical college and hospital, Tamilnadu, India.

is an Assistant Professor in the Department of General Surgery at Vels Medical College and Hospital, Tamil Nadu, India. His clinical interests include surgical oncology and head and neck pathology.

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