Mucosal melanoma

Mucosal melanoma is a rare form of melanoma that only makes up about 1 to 2% of all melanoma cases, with around 150-250 cases per year in the UK. It is just as common in people with light or dark skin tones. [1][2]

Mucosal melanomas occur in mucous membranes. These are the moist surfaces that line the cavities within our body, for example, the mouth, nose, anus or vagina. Melanomas that appear on mucous membranes and the skin (also known as cutaneous melanoma) start when melanocytes, the pigment-producing cells in the skin, grow out of control and turn cancerous. Apart from starting off the same, mucosal melanoma and skin melanoma are very different in their biology and the way they act.

For example, a known risk for developing skin melanoma is a history of exposure to the sun, especially during childhood. However, this does not increase the risk of mucosal melanoma. In fact, there are currently no known risk factors, including family (genetic) links, or environmental causes like UV exposure from the sun that have been linked to mucosal melanoma in research studies.

Doctor talking with patient

Mucosal melanomas can also be more complicated to treat than skin melanomas. One reason for this is that they are often diagnosed at a later stage. They tend to occur in less visible places and are not always pigmented (darker), which makes them even more difficult to spot.

As mucosal melanomas are very rare, you might find that once diagnosed, you may be referred to somebody who has more expertise in treating mucosal melanomas, and you may need to travel to a specialist centre rather than attend your local hospital.

Types and locations of mucosal melanomas

There are several types of mucosal melanoma and we have produced dedicated guides for patients and their support persons on the signs, symptoms, diagnosis, staging and treatment of them that you can access below. Please note that we have separate resources for uveal melanoma (melanoma of the eye).

Below you’ll find guides covering:

  • Head and Neck mucosal melanomas
  • Anorectal mucosal melanoma
  • Urogenital mucosal melanoma
  • Vulvo-vaginal mucosal melanoma

 

Head and Neck mucosal melanomas

The most common types of mucosal melanoma occur in the head and neck region and can be found in the following locations:

  • Oral mucosal melanoma – These arise in the oral cavity in the mouth
  • Sinonasal mucosal melanoma – These occur in the nasal passages of the nose
  • Pharngeal/ laryngeal mucosal melanoma – This is the least common melanoma found in the head and neck, and affects the throat

The signs, symptoms of the different types of head and neck mucosal melanoma vary and are often associated with lots of other minor conditions. An example is a nose bleed that has not stopped after 3 weeks, or a single blocked nostril that does not improve with sinus drops, in the case of sinonasal mucosal melanoma. They rely on your GP eliminating the many other harmless causes of these symptom

Head and neck mucosal melanoma patient guide
View guide and resources

Subsequently, you may be referred to a head and neck clinic that deals with mucosal melanoma. For further information on head and neck melanoma access our our dedicated web resources and guide.

Anorectal mucosal melanoma

This type of mucosal melanoma affects the areas in and around the anus, or the rectal cavity. It is very rare and the signs and symptoms of anorectal mucosal melanoma are similar to other cancers and conditions in the bowel or colon area. They can include bleeding from the rectum (back passage), change in bowel habit, persistent itching, pain, swelling or a lump. You may feel an urgent need to empty your bowels, although you may not be able to. Your GP may refer you to a colorectal surgeon.

For further information on anorectal mucosal melanoma, including diagnosis and treatment, access our dedicated web resources and guide.

View guide and resources

Urogenital mucosal melanoma

This kind of mucosal melanoma is very rare and affects the urogenital tract, including the penis, urethra and bladder. In the penis, it can affect the glans, foreskin, or urethral meatus (the opening of the urethra at the tip of the penis). A separate guide is available for vulvo-vaginal mucosal melanomas.

Symptoms vary depending on the area affected and can be similar to those of other cancers and conditions. They may include bleeding, pain or discomfort, unusual discharge, changes in passing urine, or a swelling, lump or ulcer. The affected area may be pigmented (darker in colour), but this is not always the case. Some bladder and urethral mucosal melanomas may have few or no symptoms at all and are sometimes found during investigations for another problem.

For further information on urogenital mucosal melanoma, including diagnosis and treatment, access our dedicated web resources and guide.

View guide and resources

Vulvo-vaginal mucosal melanoma

This type of mucosal melanoma is very rare and can occur in the vulval or vaginal area. The symptoms are similar to those associated with other cancers and conditions found in this area of the body. You may have a lump, a sore area and/or bleeding. You may have trouble urinating (passing water). As with skin melanomas, there may be an area which is pigmented (darker), but this is not always the case.

For further information on vulvo-vaginal mucosal melanoma, including diagnosis and treatment, access our dedicated web resources and guide.

View guide and resources

Dr Miranda Payne presented a talk on the Mucosal Melanoma Guidelines at the 2025 Melanoma Patient Conference. You can watch the full talk here.

Dr Miranda Payne – Updated Mucosal Melanoma Guidelines

Patient Stories

Philippa’s Story:

 

On Christmas day in 2021, Philippa found a small lump in her vulva and after being referred by her GP, was diagnosed with vulval mucosal melanoma. During January 2022 she had an initial operation to remove this and in March 2022 she had a single lymph node removal. Following on from this in May 2022 a PET scan revealed metastatic lymph node outside of the pelvis and Philippa started double immunotherapy treatment (ipilimumab+nivolumab). She underwent further surgeries and her latest scan shows she is cancer-free.

Read Philippa’s full story

Jonathan’s Story:

 

During September 2020 Jonathan was diagnosed with stage 2 ano-uro-genital mucosal melanoma,  and in November 2020, he underwent his first surgery to remove this. Unfortunately, the cancer had not been fully removed with clear margins and the operation had to be repeated. Jonathan has a rare mucosal melanoma which has further spread, and additional surgeries and treatments have continued, and he is now looking into alternative treatment options.

Read Jonathan’s full story

Support: Facebook Group

Mucosal Melanoma Warriors is a private Facebook support group for people with mucosal melanoma or carers of people with mucosal melanoma. It has over 1,000 members and if you have a Facebook profile you can request to join. Many people find it a huge comfort to connect with others in similar situations, however, we understand that this route of support does not benefit all as everyone’s experience is different. There is always the option to join the group and leave at a later point if your needs are not met.

References & Further resources:

[1]Abigail Gee et al.,Treatment of advanced mucosal melanoma in the immunotherapy era: A joint institutional case series.. JCO39, e21503-e21503(2021). https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.e21503

[2]Santeufemia DA et al., Current Trends in Mucosal Melanomas: An Overview. Cancers (Basel). 2023 Feb 21;15(5):1356. doi: 10.3390/cancers15051356. https://pmc.ncbi.nlm.nih.gov/articles/PMC10000120/

The Melanoma Stages and Treatment Patient Guide has a variety of resources for patients, including information about immunotherapy treatment along with detailed advice to support your health and wellbeing exploring topics such as exercise and melanoma, fatigue and mental health and melanoma.