This subtype is associated a worse prognosis than those arising from the skin.

[1]: 696 [2] Mucosal melanomas occur in the head and neck (55%), anorectal (24%) and vulvovaginal region (18%), and in the urinary tract (3%).

[3] Based on the histopathologic and clinical features, melanomas of the vulva and vagina are often considered a separate disease entity.

[5] While chemotherapy has not shown capacity to improve survival in clinical and observational studies, immune checkpoint inhibitors (e.g., pembrolizumab) have been tested in mucosal melanomas and have shown promising response rates.

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