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This research aims to present therapeutic strategies in managing oral mucosal melanoma, highlighting challenges in treatment.

April 23, 2026Open Access

Therapeutic challenges in oral mucosal melanoma: two clinical cases

IRI. Villegas Romero RRR. Román-CheuqueHospital Universitario Puerta del Mar FRF. Rodríguez-PosadasHospital Universitario Puerta del Mar

Key Points

This research aims to present therapeutic strategies in managing oral mucosal melanoma, highlighting challenges in treatment.
Presentation of two clinical cases of mucosal melanoma with detailed treatment regimens.
Use of immunotherapy agents ipilimumab and nivolumab alongside topical imiquimod.
Assessment of treatment responses and disease progression through clinical evaluations and histological examinations.
In Case 1, significant response was achieved with immunotherapy despite treatment interruption due to toxicity.
In Case 2, initial partial response was observed after the introduction of axitinib and radiotherapy.
Both cases underscore the aggressive nature of mucosal melanoma and the complexities of effective treatment.

Abstract

Background: Mucosal melanoma (MM) is a rare and aggressive malignancy (80%, axitinib (5mg/12h) was added to nivolumab, together with local and locoregional radiotherapy to the primary tumor bed and involved lymph nodes.An initial partial response was observed two months after initiation of this last-line treatment.Conclusions: MM exhibits aggressive behavior and represents a significant therapeutic challenge; ipilimumab plus nivolumab should be considered as first-line option in non-surgical cases.However, immunotherapy alone may be insufficient and is frequently associated with immune-related toxicity.Topical imiquimod administered to the oral mucosa using an intraoral splint represents a simple but rarely reported adjunctive strategy.The intraoral splint enables effective topical drug delivery in this anatomically challenging site and facilitates sustained local drug exposure.

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