Mucosal melanomas are rare and only a small portion bear BRAF mutations while cutaneous melanomas have a much higher prevalence and often harbor BRAF mutations. We present two cases in which, after a malignant melanocytic mucosal lesion with a BRAF mutation was found, the primary cutaneous source was identified and clonality confirmed between the lesions. In both cases, primary lesions occurred on the scalp, an often-overlooked site. Both lesions showed signs of regression implying that in due time these lesions could have been fully regressed and might never have been detected. In that case, the metastatic mucosal lesion would erroneously be identified as a BRAF-mutated mucosal melanoma. These cases give warrant; a careful dermatological inspection should be instigated when confronted with a BRAF-mutated mucosal melanoma. We hypothesize that some BRAF-mutated mucosal melanomas might actually represent metastases of regressed cutaneous melanomas.

黏膜黑色素瘤很少见，只有一小部分带有BRAF突变，而皮肤黑色素瘤的患病率要高得多，并且经常带有BRAF突变。我们提出了两个病例，其中，在发现具有BRAF突变的恶性黑色素细胞粘膜病变后，确定了主要皮肤来源并确认了病变之间的克隆性。在这两种情况下，原发性病变都发生在头皮上，这是一个经常被忽视的部位。两种病变都显示出消退的迹象，这意味着在适当的时候这些病变可能已经完全消退并且可能永远不会被发现。在这种情况下，转移性黏膜病变将被错误地识别为BRAF-突变的黏膜黑色素瘤。这些案件提供保证；当遇到BRAF突变的黏膜黑色素瘤时，应进行仔细的皮肤病学检查。我们假设一些BRAF突变的粘膜黑色素瘤实际上可能代表退化的皮肤黑色素瘤的转移。