台耳醫誌

Head and neck mucosal melanoma (HNMM) is a rare but highly aggressive malignancy. Owing to its insidious onset and ease of systemic dissemination, the disease often presents at an advanced stage with a poor prognosis. We report an 84-year-old female with hypertension and diabetes who presented with a mass involving the left lateral tongue and sublingual space. She denied smoking, alcohol consumption, and betel nut chewing. Histopathological and imaging studies revealed a T4 mucosal melanoma. Despite surgical management of the primary site and neck, the patient experienced regional and systemic disease progression, including supraclavicular lymphadenopathy and pulmonary metastases. Due to comorbidities and advanced age, the patient declined further systemic therapy. This case highlights the aggressive nature of HNMM. Radical resection of the tumor, combined with adjuvant radio- or systemic therapies, is essential for achieving better local control. However, systemic dissemination remains a significant challenge. In elderly patients, treatment is particularly complex due to comorbidities and reduced treatment tolerance. Therefore, the development of more effective novel systemic therapeutic strategies is needed. (J Taiwan Otolaryngol Head Neck Surg 2026; 60:78-83)