BackgroundMalignant melanoma of oral cavity is a rare condition, accounting for 0.5 % of all oral malignancies and about 1–2 % of all melanomas. Oral melanomas have extremely poor prognosis with 5 years survival rate of 12.3 %. The poor prognosis compared to cutaneous melanoma may be attributed to delay in reporting by patient and diagnosis, and apt to become ulcerated due to repeated trauma. The ‘chameleonic’ presentation of a mainly asymptomatic condition, the rarity of these lesions, the poor prognosis and the necessity of a highly specialized treatment are factors that should be seriously considered by the involved health provider.Case presentationWe present a case of 32 years old male of Han ethnicity with mucosal melanoma of upper lip, comparing his clinical presentation and histological findings at his first visit and following the recurrence. The patient complained of black discoloration on the left side of upper lip since 4 years which gradually increased in size and later involved the skin of the lip. Excision with 5 mm safety margin was performed but the patient presented with the similar lesion after three and half years of the treatment. So, again wide excision with 2 cm safety margin was performed followed by reconstruction of the lip.ConclusionThis case provides an example of aggressive behavior of mucosal melanoma and emphasizes on the fact that any pigmented lesion detected in the oral cavity may exhibit potential growth and should be submitted to biopsy to exclude malignancy. It also exemplifies of how the time of diagnosis and the evolution of a disease could be seriously influenced by patient’s behavior.

BackgroundDesmoplastic ameloblastoma (DA) is a rare variant that accounts for approximately 4–13 % of ameloblastoma, displaying significant differences in anatomical site, imaging, and histologic appearance. It has been included in WHO classification of head and neck tumor (WHO-2005) as a variant of ameloblastoma. The tumor resembles benign fibro-osseous lesion for being frequently occurring in the anterior region of jaws as a mixed radiopaque-radiolucent lesion.Case presentationWe present a case of DA in a 43-year-old female with a painless swelling in the anterior region of mandible. No fluid was evident on fine needle aspiration. A mixed lesion with multilocular appearance was evident on both panoramic radiographs as well as computed tomography scan. An incisional biopsy confirmed it to be a case of desmoplastic ameloblastoma. Segmental mandibulectomy was performed from teeth 35 to 44. The patient is on routine follow-up and is currently free of ailment.ConclusionsThe present case deserves emphasis because of its unfamiliar appearance, potentially aggressive nature and deceptive radiologic appearance maximizing the chances of misdiagnosis. So, the clinician should be alert enough to include desmoplastic ameloblastoma in differential diagnosis of any lesion/growth with mixed radiolucent-radiopaque appearance having ill-defined borders and occurring in anterior maxilla or mandible.

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