Depending on its type, melanoma can develop in different areas of skin and even nails. Mucosal melanoma is a cancer that affects mucous membranes, also known as mucosa. Mucous membranes are soft, moist tissues such as the lips or inside the mouth, throat, or nose.

In this article, we’ll cover what mucosal melanoma can look like in the lips, mouth, and nose. We’ll also describe what symptoms to watch out for in general and how this type of cancer is diagnosed. Your doctor can answer more questions about your individual condition.

What Is Mucosal Melanoma?

Mucosal melanoma occurs when cells called melanocytes become cancerous and form tumors in the mucosa. Melanocytes produce the pigment melanin, which provides color to skin, hair, eyes, and other tissues.

Mucosal melanoma is much rarer than melanoma in other areas of skin. Only about 1 percent of all melanoma cases are mucosal melanoma. Since this type of skin cancer is so rare, many people may be unfamiliar with what mucosal melanoma looks like or how it can affect the body. By understanding more about the signs and symptoms of mucosal melanoma, you can recognize when something doesn’t seem right.

Signs and Symptoms of Mucosal Melanoma

In people with melanoma, cancerous melanocytes bring excess pigment to the affected part of the body. This usually leads to lesions (abnormal marks) that are very dark. However, melanoma can also be amelanotic, meaning the lesion has no color.

Symptoms of mucosal melanoma depend on where the cancer is located. Commonly affected regions of the body include the following:

• Respiratory tract
• Digestive tract
• Genitals, including the vagina and vulva (external area around the vagina)
• Urinary tract

About 50 percent of mucosal melanoma cases start in the head and neck, including the face — specifically, the nose and mouth. When tumors form inside the mouth and around the lips, the condition is known as oral mucosal melanoma. Sinonasal mucosal melanoma refers to disease that forms in and around the nose.

Mucosal Melanoma of the Mouth and Lips

Mucosal melanoma can form dark lesions in different areas of the mouth. In many cases, these lesions are on the roof of the mouth or around the teeth. The disease may also affect the floor of the mouth underneath the tongue. Mucosal melanoma can also form on the:

• Tongue
• Inside of the cheeks
• Uvula (the piece of flesh that hangs at the back of the throat)

When mucosal melanoma affects the lips, they can become swollen and dark. The surrounding skin may be very dark or have less pigment.

Some people with oral mucosal melanoma may not experience any symptoms. However, others may have symptoms such as:

• Bleeding inside the mouth
• Pain
• Mouth ulcers (open sores)
• Difficulty swallowing

Mucosal Melanoma Inside the Nose

Mucosal melanoma can form in the area above and behind the nose — also known as the nasal cavity — or other areas inside the nose. The disease can also affect the paranasal sinuses, which are the spaces between the bones that surround the nose. Sinonasal mucosal melanoma can appear as a large mass inside the affected area.

If the disease is still in the early stages, there may be no symptoms. However, if the disease is more advanced, the mass can often cause nasal obstruction — a blockage in one side of the nose — and nosebleeds. Other symptoms of sinonasal mucosal melanoma include:

• Runny nose
• Loss of sense of smell
• Bulging eyeballs
• Headache
• Watery eyes
• Double vision
• Facial pain

Symptoms caused by mucosal melanoma can also be caused by other conditions. This can make it challenging to diagnose the condition based on symptoms alone.

Diagnosis of Mucosal Melanoma

If your doctor discovers a lesion that appears to be mucosal melanoma, they may use a number of tests to confirm a diagnosis.

Imaging Tests

Imaging tests allow doctors to study tissues inside the body and can help identify tumors. Computed tomography (CT) uses focused X-rays. CT scans can look at mucosal melanoma tumors and determine if the cancer has spread. Magnetic resonance imaging (MRI) may also be used to help diagnose mucosal melanoma.

Biopsy

To get more information about your cancer, a doctor may perform a biopsy. This procedure involves removing a sample of the tumor tissue to be studied more closely under a microscope. Based on the cells’ appearance, a doctor can confirm a diagnosis of mucosal melanoma.

Genetic Tests

Mucosal melanoma develops when mutations (changes) happen in melanocytes. Your doctor may recommend testing to look for specific gene mutations in your cancer cells. This can help them understand your melanoma better and know whether certain treatments may be effective.

Prognosis of Mucosal Melanoma

Compared with skin melanoma, mucosal melanoma tends to be more aggressive (faster growing). Additionally, areas of mucosa are not as readily visible as the rest of your skin, making mucosal melanoma lesions harder to notice. This can delay diagnosis until the disease is already in the advanced stages, leading to an overall poor prognosis (outlook).

Research studies look at survival rates to understand the prognosis of mucosal melanoma. Survival rates measure the percentage of people who are still alive five years after diagnosis. The 5-year survival rate is approximately 25 percent to 30 percent for oral mucosal melanoma and 20 percent to 40 percent for sinonasal mucosal melanoma. However, your individual prognosis will depend on many factors. Your doctor can help you better understand how to improve your outlook.

Fortunately, researchers continue to look for better treatments for people living with mucosal melanoma. Clinical studies have found that newer therapies may be effective for people with certain types of mucosal melanoma. As more effective treatment options become available, people with mucosal melanoma can, hopefully, live longer with a better quality of life.

Recognize the Warning Signs

Mucosal melanoma is a rare disease that can be hard to diagnose. Because the disease is aggressive, an earlier diagnosis is crucial for a better outcome. You can help yourself by learning the warning signs — if you notice any unusual symptoms, mention these to your doctor right away. They’ll study your particular case and decide on the best treatment option.

If you’re diagnosed with mucosal melanoma that’s still in the early stages, surgery may be the only treatment you need. However, some people are diagnosed with metastatic melanoma, meaning the cancer has spread to the lymph nodes or other parts of the body. In this case, you’ll need additional treatment. Your doctor may recommend the following:

• Radiotherapy — or radiation therapy — which uses high-powered X-rays to shrink tumors
• Targeted therapy drugs that kill tumor cells with certain gene mutations, such as BRAF
• Immunotherapy, which harnesses the immune system to better fight cancer and may also be effective for some people with mucosal melanoma

Although the future may be uncertain, your cancer care team can help you along your journey. Together, you can decide on a treatment plan that will give you the best chance at a longer, healthier life.

Talk With Others Who Understand

MyMelanomaTeam is the social support network for people with melanoma and their loved ones. On MyMelanomaTeam, members come together to ask questions, give advice, and share their stories with others who understand.

Have you or a loved one been diagnosed with mucosal melanoma? What symptoms have you experienced, and which treatments have you received? Share your insights in the comments below, or start a conversation by posting on your Activities page.