Lip Melanoma: A Systematic Review of the Literature.

Abstract

Lip melanoma is a rare malignant neoplasm arising at the cutaneous-mucosal interface, and its clinicopathologic profile remains insufficiently characterized. We conducted a systematic review to synthesize current evidence on its epidemiology, clinicopathological features, management, and outcomes. Electronic searches were performed in PubMed, Scopus, Embase, Web of Science, and LILACS, supplemented by manual scrutiny and gray-literature sources. Case reports and case series were included. Data were analyzed descriptively and analytically. Forty-three studies describing 139 affected individuals were included. Individuals were predominantly male (71.2%), with a mean age of 51.1 years. Most lesions involved the lower lip (63.8%) and presented clinically as pigmented, nodular, and frequently ulcerated lesions; approximately 8% were amelanotic. Histopathologic patterns included superficial spreading, lentiginous, nodular, desmoplastic, and neurotropic melanoma. Surgery was the mainstay therapeutic modality, often requiring labial reconstruction. Local recurrence occurred in 25.9% of cases and distant metastasis in 38.8%. Crude overall survival was approximately 48%, whereas Kaplan-Meier analysis demonstrated an estimated 5-year survival of 74%. This first review of lip melanoma underscores the need for tailored management strategies. Continued accumulation of standardized clinicopathological data remains essential to refine prognostic stratification and guide clinical decision-making.