Oral mucosal melanoma (OMM) is a rare and aggressive malignancy with a poor prognosis and high metastatic potential. Its subtle clinical presentation and diagnostic challenges often result in late-stage detection, complicating treatment. Advanced imaging techniques, such as PET and MRI, have significantly improved staging accuracy. Additionally, noninvasive methods and molecular profiling show promise for early detection and personalized treatments. Surgical resection remains the cornerstone of treatment, complemented by radiotherapy, including carbon-ion therapy, and systemic therapies like as immune checkpoint inhibitors and targeted therapies. Emerging approaches, such as gene therapy, adoptive cell transfer, and combination treatments, aim to enhance therapeutic outcomes. Multidisciplinary care is crucial to address the complex needs of patients, balancing oncologic control with functional and aesthetic considerations. Despite these advancements, outcomes remain poor, underscoring the urgent need for further research into the molecular mechanisms of OMM and innovative therapeutic strategies. Collaboration across research and clinical disciplines is key to driving progress and enhance patient outcomes.
