A Malignant Melanoma Associated with a Blue Nevus of the Lip

Lee, Hye Young; Na, So Young; Son, Young Min; Kang, Hong Kyu; Baek, Jin Ok; Lee, Jong Rok; Roh, Joo Young

doi:10.5021/ad.2010.22.1.119

Cited by 18 publications

(17 citation statements)

References 18 publications

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“…Overall, there is a slight male preponderance described in the literature (56 lesions in males compared with 51 women)-in contrast to our findings (9 men to 15 women). The most common anatomic site for these lesions is the head and neck region in 52 cases, 4,5,7,11,13,[15][16][17][18][19][20][21]23,24,27,28,31,33,36,39,42,[46][47][48]51,53 followed by the trunk in 28 cases, 4,5,7,[11][12][13]16,18,25,32,34,35,38,43,45,50,52 the lower extremity in 11 cases, 4,7,13,14,26,30,33...…”

Section: Discussionmentioning

confidence: 99%

“…Regarding pathologic findings, the reported cases (in order of frequency) included malignant melanocytic proliferations mimicking a cellular blue nevus but lacking an identifiable benign component (in 38% of cases) 5,11,[13][14][15]18,20,25,28,30,33,36,47,49 or melanomas arising in association with a distinctive blue nevus component, including (a) cellular blue nevus (26%), 4,5,11,16,18,29,40,46,50,51,53 (b) common blue nevus (21%), 5,13,22,24,27,31,32,34,37,39,41,43,52 (c) both cellular and common blue nevus (13%), 12,16,21,23,35,38,44,45,48 (d) neurocristic hamartoma (1%) 42 and (e) nevus of Ota (1%). 17 In contrast, all of the cases in our series consisted of distinctly biphenotypic melanocytic proliferations (melanoma together with a benign blue nevus component).…”

Section: Discussionmentioning

confidence: 99%

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Melanoma arising in association with blue nevus: a clinical and pathologic study of 24 cases and comprehensive review of the literature

et al. 2014

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Melanomas arising in association with blue nevi or mimicking cellular blue nevi comprise a relatively rare and heterogeneous group of melanomas. It remains controversial which prognostic indicators predictive of outcome in conventional cutaneous melanomas are applicable to this type of melanoma. Here, we describe the clinical and histopathologic features of 24 melanomas arising in association with blue nevi and correlate these with clinical outcome. The mean patient age was 49 years (range: 23-85) with a slight female predominance (15 females:9 males). The most common anatomic locations included the head and neck region (50%), the trunk (21%), and the buttock/sacrococcygeum (17%). Histologically, the tumors were typically situated in the mid to deep dermis with variable involvement of the subcutis, but uniformly lacked a prominent intraepithelial component. The mean tumor thickness (defined as either the standard Breslow thickness or, if not available due to the lack of orientation or lack of epidermis, the largest tumor dimension) was 20.9 mm (range: 0.6-130 mm). The mean mitotic figure count was 6.5/mm 2 (range: 1-30/mm 2 ). Perineural invasion was common (38%). Followup was available for 21 cases (median 2.1 years). The median overall survival, recurrence-free survival, time to local recurrence, and time to distant recurrence were 5.2, 0.7, 2.6, and 1.6 years, respectively. Logistic regression analyses demonstrated a significant association between tumor thickness and recurrence-free survival (hazard ratio ¼ 1.02 per mm; P ¼ 0.04) and reduced time to distant metastasis (hazard ratio ¼ 1.03 per mm; P ¼ 0.02) with a similar trend toward reduced time to local recurrence (hazard ratio ¼ 1.02 per mm; P ¼ 0.07). No other parameters (age, anatomic location, mitotic figures, lymphovascular or perineural invasion, or type of associated blue nevus) emerged as significant. In addition, we provide a comprehensive review of 109 cases of melanoma blue nevus type described in the English literature and summarize our findings in this context.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Melanoma arising in association with blue nevus: a clinical and pathologic study of 24 cases and comprehensive review of the literature

et al. 2014

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“…Necrosis and ulcerations are not unusual. 6 The histopathology differential diagnosis is extensive; therefore, in some occasions, immune-staining is required. Cells are positive for S-100, HMB-45, Melan-A, tirosinase and Microphtalmic-associated Transcription factor (MITF).…”

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confidence: 99%

A case of oral mucosal melanoma. Clinical and dermoscopic correlation.

Hajar-Serviansky

Gutiérrez-Mendoza²,

Galvan³

et al. 2012

J Dermatol Case Rep

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Background: Most patients with oral mucosal melanoma have had a mucosal hyper pigmented area for months or even years before the diagnosis, it is important to consider the differential diagnosis of mucosal melanoma, which in many cases is a difficult diagnosis and because of the aggressive biological behavior of mucosal melanoma it is important to do a quick diagnosis. Main observation:A 40-year-old Mexican male patient, presented with a lesion on the lower right half of the lip covering almost the entire vermillion border, 1 mm below the white roll. The lesion was a 1.5 x 4 cm pigmented macule with asymmetric and irregular borders and colors. Dermoscopy showed a multi component pattern. An incision biopsy was performed under the impression of mucosal melanoma. The pathologic report described a Clark I vermillion edge mucosal melanoma in situ. Conclusions:This case had confounding clinical signs that could have misguided the clinician. But dermoscopy proved to be useful when suspecting a malignant lesion, which prompted a biopsy and a correct diagnosis. (J Dermatol Case Rep. 2012; 6(1): 1-4) A case of oral mucosal melanoma. Clinical and dermoscopic correlation.Tamar Hajar-Serviansky, Daniela Gutierrez-Mendoza, Iris L. Galvan, Lorena Lammoglia-Ordiales, Adalberto Mosqueda-Taylor, Maria de Lourdes Hernandez-Cázares, Sonia Toussaint-Caire Dermatology Division, Hospital General "Dr. Manuel Gea González", Mexico City, Mexico. IntroductionThere are many lesions that present with an increase in oral mucosal pigmentation, with an intrinsic and extrinsic origin. Since most patients with oral mucosal melanoma have had a mucosal hyper pigmented area for months or even years before the diagnosis, it is important to consider the differential diagnosis of mucosal melanoma. Case ReportA 40-year-old Mexican male patient, Fitzpatrick's skin type III, presented with a lesion on the lower right half of the lip covering almost the entire vermillion border, 1 mm below the white roll. The lesion was a 1.5 x 4 cm pigmented macule with asymmetric and irregular borders and colors. The white roll had an infiltrated area that was slightly elevated and deformed with grouped vesicles and erythema (Fig. 1).According to the patient, the lesion had always been present, and was confident the elevation and erythema were in the hard palate and upper alveolar ridge. Jaw, retromolar, trigone, and floor of the mouth were involved in 3 cases (8.57%); 3 melanomas (8.57%) were detected in the labial mucosa and 2 (5.71%) on buccal/vestibular mucosa. Only 1 case (2.86%) was diagnosed on the lateral border of tongue, and in 1 case (2.86%), they could not identify the site of the lesion. 7The biological behavior of mucosal melanoma notoriously differs from the one shown in case of skin melanomas. Likely reasons are late diagnosis and treatment; anatomic differences in location, a greater blood and lymphatic flow in mucosa, easing its spread and differences in its genetic profile. For the above, in general, it has a bad prognosis with a 5-ye...

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“…On the other hand, blue nevus is a benign acquired melanocitic lesion that usually also presents as an asymptomatic, blue-gray or slate-blue smooth-surfaced macule or papule measuring less than 1 cm 3,9 . Besides rare in oral cavity, the oral blue nevus is the second most common type of oral melanocytic nevi 15,19,21 . It is characterized by a proliferation of dermal melanocytes within the deep connective tissue at some distance from the surface epithelium, which accounts for the blue colour 3 .…”

Section: Discussionmentioning

confidence: 99%

“…It is characterized by a proliferation of dermal melanocytes within the deep connective tissue at some distance from the surface epithelium, which accounts for the blue colour 3 . Intraoral lesions are also frequently in hard palate 15,[18][19][20][21] and between the third and fifth decades of life. Females tend to be more commonly affected than males.…”

Section: Discussionmentioning

confidence: 99%

Pigmented lesion in hard palate

Molini¹,

Velloso²,

Silva³

et al. 2016

J Oral Diag

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Oral pigmented lesions are commonly noted in odontologic practice. Clinical features of malignant and benign lesions show enough similarity that makes clinical differentiation difficult or impossible. Exogenous pigmentations in orign are usually due to a foreign-body implantation in the oral mucosa and the graphite as an exogenous source of pigmentation in the oral cavity has been reported sporadically. This report is presents a case of a graphite tattoo in hard palate of a young female adult and discusses the diferential diagnosis with blue nevus and early oral melanoma. It reinforces that oral pigmented lesions must be carefully evaluated and a malignant lesion should not be ignored until a final diagnosis be established.

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A Malignant Melanoma Associated with a Blue Nevus of the Lip

Cited by 18 publications

References 18 publications

Melanoma arising in association with blue nevus: a clinical and pathologic study of 24 cases and comprehensive review of the literature

Melanoma arising in association with blue nevus: a clinical and pathologic study of 24 cases and comprehensive review of the literature

A case of oral mucosal melanoma. Clinical and dermoscopic correlation.

Pigmented lesion in hard palate

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