Lip Melanoma: A Systematic Review of the Literature

BACKGROUND: 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. METHODS: 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. RESULTS: 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%. CONCLUSIONS: 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.