A Large Oral Melanoma: A Case Report of a Rare but Aggressive Malignancy

Abstract

A variety of black-pigmented lesions of the oral cavity can be found, ranging from harmless benign lesions such as melanotic macule, smoker’s melanosis, amalgam/graphite tattoos, and pigmented nevus to a life-threatening oral malignant melanoma. Oral melanoma is a rare and aggressive malignant tumor that originates from melanocytes’ proliferation and accounts for only 0.5% of all oral malignancies. The etiology is unknown. Most oral melanomas are present at the palate and the upper alveolar ridge, whereas occurrences at the buccal mucosa, the lower alveolar ridge, and the lip are rare, with only a few reports in the literature. The diagnosis is confirmed by a biopsy. The prognosis is poor, with a 5-year survival rate of ~20%. In this report, we present a case of large oral melanoma at the right buccal mucosa involving the right lower alveolar ridge and lip commissure, which are relatively unusual locations for oral melanoma. In addition, immunohistochemical markers used for diagnostic, therapeutic, and prognostic decision-making of oral melanoma are also discussed.

Oral malignant melanoma of the lower jaw—a case report with immunohistochemical investigations

“…The physical characteristics and biological behaviour of ORAL MUCOSAL MELANOMAS (OMM) may exhibit great heterogeneity, which may make the clinical diagnosis very challenging [ 12 , 5 ]. Amalgam tattoo, Nevi, post-inflammatory pigmentation, melanotic macule, melanoacanthoma, smoking-associated melanosis, melanoplakia, Addison's illness, Peutz-Jeghur syndrome and Kaposi's sarcoma are all included in the differential diagnosis [ 4 , 12 ].…”

“…Broad surgical excision with appropriate negative margins, neck dissection with or without radiation and chemotherapy are the usual therapies for malignant melanoma. In contrast to cutaneous melanoma, OMM may be treated with radiotherapy if the condition is localised [ 5 ].…”

“…The cutaneous and ocular forms of melanoma are the most prevalent types [ 4 ]. Only 0.5% of all head and neck neoplasms are mucosal melanomas, which is rare and affects the sinonasal cavity, oral cavity, pharynx, larynx and upper oesophagus [ 4 , 5 ].…”