ORAL MUCOSAL MELANOMAS - THE WESTOP BANFF WORKSHOP PROCEEDINGS

A workshop to discuss primary oral melanomas was convened at the annua l Western Society of Teachers of Oral Pathology meeting in Bannf, Albe rta, Canada. Fifty oral melanomas, identified from the files of the pa rticipants, were reviewed in order to better understand the clinical f eatures, histologic spectrum, and natural history of these perplexing lesions. Results confirmed that oral melanomas occur in adults almost three times more frequently in men than women and have a decided predi lection for the palate and gingiva. Some lesions exhibit a clinically detectable and prolonged in situ growth phase, whereas others seem to lack this property and exhibit only or predominantly invasive characte ristics. Recurrences, metastases, and death from tumor were characteri stic of the follow-up of a limited number of patients. Until definitiv e prospective data are collected that elucidate natural history, oral mucosal melanomas should be tracked separately from cutaneous lesions, All oral pigmented lesions that are not clinically diagnostic should be biopsied. Lesions with equivocal histopathologic features might be referred to as ''atypical melanocytic proliferation'' and should be ex cised. Recognition of lesions in an early in situ phase and aggressive treatment should have a favorable effect on prognosis. To enhance fut ure or prospective study of these rare neoplasms, guidelines for repor ting oral melanomas are suggested.