Mucosal Melanoma of the Oral Cavity: Prognostic Factors Influencing Patient Survival Outcomes.

Background/Objectives: Oral mucosal melanoma is rare and associated with poor prognosis. This study aims to identify clinical and molecular factors influencing survival by synthesizing published cases together with one original case. Methods: A systematic review was conducted. Relevant clinical, histopathological, and follow-up parameters were compared across studies. Results: A total of 21 publications describing 42 patients were reviewed, and the data were aggregated with our patient, yielding 43 patients in total. Our case describing a 66-year-old male with 14 years of disease-free survival despite multiple excisions illustrated the potential for long-term survival despite poor prognosis. Favorable prognostic indicators listed in the literature included preserved expression of BAP1, p53, BCL2, and p16, the presence of tumor-infiltrating lymphocytes, smaller tumor size and thickness, and the absence of vascular invasion. Longer follow-up periods were most often observed in younger patients without lymphadenopathy, distant metastasis, or local recurrence. Conclusions: This review highlights prognostic features in oral mucosal melanoma but also underscores exceptions, demonstrating that survival cannot be fully explained by current clinical and molecular criteria.