Malignant Melanoma Metastatic to the Larynx: A Case Report

This study is a systematic review of the literature that was performed to clarify the natural history and treatment outcomes of upper aerodigestive tract metastases from cutaneous melanoma. A search of the MEDLINE database was undertaken from 1950 to 2013 to identify relevant manuscripts for this review. Article inclusion required cases with documentation of previous cutaneous melanoma primary lesions, adequate survival data, and description of metastatic treatment. Individual patient data were extracted from source articles for analysis of survival outcomes. A systematic search revealed 34 relevant articles with 37 cases for inclusion. Metastases were identified throughout the upper aerodigestive tract with a predilection for the oropharynx, larynx, and oral cavity. Treatment outcomes were estimated with the Kaplan-Meier method, with survival of 37% and 16% at 1 and 5 years, respectively. As expected from previous reports, 73% presented with disseminated disease burden with almost universally poor prognosis despite locoregional or systemic therapy. Conversely, a group of patients with limited metastatic burden had improved treatment response with a 1-year survival of 90%, denoting a hazard ratio of 9.7332 (95% confidence interval, 4.5-21.1) for disseminated disease in comparison. Upper aerodigestive tract metastases of melanoma thus are rare clinical entities that in general present in the setting of disseminated disease and evidently necessitate a focus on palliation. In contrast, for those with a limited metastatic burden, aggressive multimodality therapy including complete metastectomy can produce a significant survival advantage.

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“…Characteristics of the 37 included patients are shown in Table I . All were adults aged 21 to 73 years with a 1.6:1 male to female ratio.…”

Section: Resultsmentioning

confidence: 99%

Metastatic melanoma to the upper aerodigestive tract

Mifsud

Padhya

2013

The Laryngoscope

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“…Most articles identified after the search were not eligible for analysis, due to the fact that they referred either to the wrong disease, to primary mucosal melanoma or to laryngeal metastases of another condition. To our knowledge, this is the first article on this topic after Arabi Mianroodi et al reported a similar case in 2013 and Santos RS et al documented a case series of four patients in 2016 [15,16].…”

Section: Discussionmentioning

confidence: 70%

“…The mean patient age was 56-years-old and average time period to larynx metastasis was 4.3 years. Interestingly, most patients were men (19 out of 24 patients, 79.16%), while women represented only 20.84% of patients (5 out of 24 cases) [15,16,33,[44][45][46][47][48][49][50][51][52][53][54][55][56][57].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Malignant Melanoma Metastatic to the Larynx and Trachea: A Case Report and Review of the Literature

Ciolofan

Mogoantă

Ioniță

et al. 2023

Life

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Malignant melanoma rarely develops in mucous membranes. Statistical data show that approximately 0.6–9.3% of patients with cutaneous malignant melanoma will develop metastases in the upper aerodigestive tract mucosa, and within these metastatic sites, the least common are the laryngeal and tracheobronchial ones. This exceedingly rare clinical entity has no clear treatment recommendations; radical surgery does not seem to benefit the patient in term of life expectancy. We present the case of a 56-year-old male patient diagnosed with laryngeal and tracheobronchial melanoma metastases. Prior to admission to our clinic the patient had a personal history of malignant melanoma of the nuchal region operated on 7 years ago, malignant melanoma of the gallbladder and metastatic left axillary polyadenopathy for which he underwent surgical treatment 3 months prior. Histopathological and immunohistochemical reports established the diagnosis of laryngeal metastasis of malignant melanoma. Genetic molecular analysis was positive for B-Raf (BRAF) gene and hence Vemurafenib was administered, with a favorable outcome at the one-year follow-up. Nevertheless, there are currently no clear universally accepted guidelines for the treatment of laryngeal melanoma, mainly due to the rarity of this clinical entity. We conducted a review of similar cases reported in the literature. Interestingly, reviewing the cases reported in the literature, it appears that laryngeal metastases of a primary cutaneous melanoma are more common in men, with an average time to metastasis of 4.3 years.

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