Discussion

Mucosal melanoma has an epidemiology, biology, and behavioral phenotype that are distinct from that of cutaneous melanoma. It is rare, comprising only 1.3% of all melanomas. 1 Outcomes are poor: 2-and 5-year survival rates are 49% and 25%, respectively. 1 It may arise from any mucosal surface, including the sinonasal and oral cavities, or anorectal and vulvovaginal regions. Mucosal melanoma is frequently associated with a multifocal presentation and a substantial in situ component, which render complete surgical resection difficult. Local recurrence is common even when negative margins are achieved. 2 Adjuvant radiation has demonstrated some efficacy in decreasing local recurrence 3; however, its use is limited by tissue tolerance and toxicity. 4 For this reason, methods to improve local control in this disease are needed. We present a case series of three individuals in whom topical treatment with imiquimod resulted in local control of recurrent mucosal melanoma.