Oumeish (1997) studied the epidemiologic aspects of cutaneous malignant melanoma among Jordanians. The clinical and the histopathologic feature of 138 melanoma patients (86 men, median age 56; 52 women, median age 53) seen during the period November 1969-May 1994 were studied. Malignant melanoma was found to be more common in men than women, in the ratio of approximately 2:1, due to the higher exposure of men to sunlight, and occurred more in people with skin types I, II, and III, and less in people with skin types IV and V. The majority of cases were of the superficial spreading variety, followed by the nodular, lentigo maligna, and acrolentiginous melanomas, respectively. Oumeish (1997) concluded that the incidence of cutaneous malignant melanoma, formerly considered a rare tumor in Jordan, is now recognized to be on the increase and that exposure to sunlight seems to be the most prominent risk factor in the development of this tumor among Jordanians.

Srinivasan et al. (1993) reported intracerebral metastasis in a patient who presented with malignant melanoma of the scalp. This 65-year old male presented with a circular lesion (1.5 cm in diameter) of the scalp in the fronto-parietal area of three weeks duration. The lesion was raised and ulcerated with slight pigmentation on the edges and bled on touch, but was not fixed to the calvarium. There was no history of a mole or trauma and there was no cervical lymphadenopathy on clinical examination. Skull and chest X-rays were normal with no periosteal or bone infiltration in the former study. A clinical diagnosis of granuloma pyogenicum was made and a differential diagnosis of melanoma was kept in mind. The histological report of the excision biopsy revealed malignant melanoma. On the fourth postoperative day, the patient developed right sided hemiplegia and CT scan of the brain revealed a large radiolucent space occupying lesion in the left parietal lobe which was removed via a left parietal craniotomy approach, after which the patient's neurological status improved. Histological examination showed metastatic malignant melanoma of the brain. Any micro-metastasis of the brain was dealt with by radiotherapy to the brain. Metastasis to other sites like the lung and liver were excluded by investigations. Since the patient had hematogenous spread to the brain with no lymphadenopathy, wide excision of the biopsy scar over the scalp and left radical neck dissection were not done. On follow up, eight months later the patient was having a normal life. Srinivasan et al. (1993) added that over a period of five years, they came across two cases with secondaries from melanoma (primary sites were foot and scalp). [Srinivasan V, Thomas C, Lad SD. Cutaneous malignant melanoma with metastatic intracerebral space occupying lesion. Oman Med J. 1993; 10(1):31-5.]

Pillai et al (1998) reported a primary amelanotic melanoma of the tongue in a 24-year old Omani male who presented with a one year's history of painless tongue swelling, which occasionally bled. He used to smoke two to three packets of cigarettes per day. This 0.75 cm swelling on the centre of the dorsum of the tongue was raised, firm, and had smooth surface. There was no regional lymphadenopathy. Investigations were normal. The swelling was surgically excised and histopathological examination showed brownish tissue (15x1x0.5 cm) with a whitish elevation on one side, with whitish and brownish areas on the cut surface. Microscopically, there was an area of ulceration with neoplasm beneath, composed of oval, polygonal, or spindle-shaped cells with eosinophilic cytoplasm, vesicular nuclei and prominent nucleoli. These cells were arranged in alveolar, sheets, or interlacing bundles infiltrating in between muscle fibers. The covering epithelium had pseudoepitheliomatous hyperplasia, and there were vascular emboli with no oral melanosis. Immunohistochemical staining revealed positivity for S-100 and Vimentin, but these cells were negative for keratin and desmin with occasional ones showing positivity for HMB-45. A diagnosis of amelanotic melanoma of the tongue was made according to the above findings. The wound healed without scar formation and after two months he was advised to undergo wider margin re-excision with suprahyoid node dissection. [Pillai R, Devi KRL, Sriganesh S, Pandit PN. Primary amelanotic melanoma of tongue, a case report. Oman Med J. 1998; 15(1):24-5.]

Sawardekar (2005) determined the prevalence of isolated minor congenital anomalies in 21988 births between 1993 and 2002 using data from the Nizwa Hospital register of congenital anomalies. A total of five children (three males and two females) with melanocytic nevi were born during this period, giving the condition a prevalence of 0.22 per 1000 births.