Malignan melanoma (MM) is one of the rare tumours, although its incidence is rising by 4 - 5 % p.a. Some 20 % melanomas are in the area of the head and neck. The mucosal form is the least frequent and accounts for 1.4 % of all MM. There are differences in the geographical incidence. In the Czech Republic the contemporary incidence is 10.2/100 000 population (8). Consistent with the low incidence, also the number of publications is small. Treatment of these tumours is contro- versial - using surgery, actinotherapy, immunochemotherapy and a combination of all techniques. The prognosis is poor, five-year survival varies between 15 - 30 %. The present study on mucosal melanomas of the ENT area and ENT skin area is retrospective, based on health records of 25 patients treated at the ENT and Head and Neck Surgical Clinic of the Faculty Hospital in Motol and First Medical Faculty Charles University and the Chair of Postgraduate Medical Training in Prague between 1990 and 1998. The health status was assessed by contact in writing, by phone or personal contact with the patient or his family. The group comprised 14 women and 11 men, mean age 62 years, range 19 - 85 years. There were 11 skin melanomas, three times on the outer nose, five times on the ear lobe, three times on the eyelid and in the temporal region. Three times cervical metastases of melanomas with a primary localization elsewhere were involved. There were 11 mucosal melanomas with a predominance of nasal ones —9- and two in the pharynx. The method of choice in all patients was surgery which was four times followed by actinotherapy, four times by immunochemotherapy and fives times by a combination of the two methods. The most frequently used pattern of chemotherapy was that of Khayat: cycloplatinun 600 mg i.v. + Intron A 5 million u. s.c. three times per week + Proleukin 1 vial s.c./day. A total of six cycles after three-week intervals. Actinotherapy was applied fractionated, 8 Gy once per week up to a total dose of 32 Gy. Block dissection was performed in one patient with mucosal and seven patients with skin melanoma. Five-year survival in the entire group was recorded in 30 % patients, in the group of skin melanomas in 27 %, in the group of mucosal melanomas in 33 %. Although in the literature a poorer prognosis of mucosal forms is reported, this was not the case in our group. We detected melanoms of “two speeds”. Some fulminant, rapidly metastatizing, and conversely melanomas of local tropism, with a local relapse but long-term survival.

        Key words: malignant melanoma, mucosal melanoma, nasal cavity, pharynx, tonsil, immuno-