What should you know about oral mucosal melanoma?

Mucosal melanoma develops in the pigmented cells of a moist lining, including the gums, palate or other parts of the mouth. It may appear as a dark or uneven patch, but colour can vary; a sore, swelling, bleeding spot or loose-feeling tooth can also need assessment. Examination cannot confirm the diagnosis, so a biopsy is used. Pathology helps identify melanoma and describes features that influence treatment. Staging may include examination of nearby nodes and imaging for areas outside the mouth. This is different from assuming that every oral dark spot is melanoma: many mouth changes have other explanations.

Book an appointment with a dentist or doctor for any mouth lesion that persists, changes, bleeds or does not heal. Avoid repeatedly scraping or picking the area. If melanoma is confirmed, ask for coordinated care involving oral surgery, dermatology and oncology as appropriate. Surgery may be used to remove the primary lesion, while selected patients may be offered lymph-node assessment or immunotherapy when disease features and staging support it. Keep every appointment, report treatment effects early and use the care team’s advice for oral hygiene, pain control and nutrition.

Get urgent help for uncontrolled mouth bleeding, rapidly worsening swelling, breathing difficulty, inability to swallow liquids or signs of dehydration. After a biopsy or operation, contact the team for fever, spreading redness, pus, increasing swelling or pain that is not controlled by the agreed plan. New neurological symptoms such as severe headache, weakness, confusion or seizures need emergency assessment.

Where is the lesion and what did the biopsy show? What staging tests are appropriate? Can surgery remove it while preserving oral function? Should nearby lymph nodes be assessed? Would immunotherapy be considered? Who should I call about bleeding, feeding or medication effects?