Therapeutic challenges in oral mucosal melanoma: two clinical cases

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.